Return one copy of this form
to the Committee Chair and one copy to the Executive Director by April
7, 2006 |
| Lacrosse Committee Chairperson | Executive Director |
| Shannon McHale St. John Fisher College 3690 E. Avenue Rochester, NY 14618 585-385-5219(W) 585-385-7308(F) smchale@sjfc.edu |
Bernadette Macca - Utica College NYSWCAA 1600 Burrstone Rd Utica, NY 13502 315-792-3182 (P) 315-792-3211 (F) bmacca@utica.edu |
| 1. |
Name of Member School
______________________________________
(Please Check only one) WILL _________ WILL NOT _______ compete in the 2006 NYSWCAA Lacrosse Championship.
|
| 2. |
Our College or University
(Please Check only one) WILL _________ WILL NOT ____ host the 2006 NYSWCAA LACROSSE Championships if we are the highest seed. |
| 3. |
We have a School Policy that if our team is below .500 we will NOT participate in this tournament. YES __________ NO __________ |
| 4. |
Championship Packets will be mailed, faxed or e-mailed to the coach at the participating institutions. |
| 5. |
Entry Fee of $300.00 is due once you are selected to participate. (checks should be made out to NYSWCAA and sent to Shannon McHale at St. John Fisher College) A $100.00 fine will be imposed for late declarations. If your school decides to withdraw from the tournament, it must be done before "Selection and Seeding" or the penalty will be loss of entry fee and eligibility for the following year's championship. |
| 6. | Head Coach - Office Phone ______________________________ |
| 7. | Head Coach - Fax ______________________________________ |
| 8. | Head Coach - E-mail ____________________________________ |
| 9. |
ASSUMPTION OF RISK WAIVER As Athletic Director of _____________________________________, I hereby certify that our lacrosse players, coaches, and other team personnel are covered by their own insurance plan or secondary carrier (i.e. college insurance) and therefore waive the responsibility of the NYSWCAA and the host institutions for insurance coverage. SIGNATURE OF ATHLETIC DIRECTOR
______ Yes, I want to be notified if our team has been selected. My Phone number is ________________________ DATE: |
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Last Updated: 08/14/05