Lacrosse Championship -Declaration of Intent
2006 

Return one copy of this form to the Committee Chair and one copy to the Executive Director by April 7, 2006 
The declaration can be sent by fax or by mail.
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		 Victoria Chun
NYSWCAA
7248 Butternut Lane
Hamilton, NY 13346
315-824-8911 (P)
315-824-8911 (F)
vchun@nyswcaa.org
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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