TEMPLE LACROSSE TO HOST "FEBRUARY FURY"

PHILADELPHIA - The Temple lacrosse team will host "February Fury" 2004 Lacrosse Tournament on Saturday, February 28, 2004. Further information is below:

WHO: School Girls, Grades 8-12

WHEN: Saturday, February 28, 2004 (rain date Sunday Feb. 29, 2004)

WHERE: Temple University, Geasy Astro-Turf Field

Teams must include 4 field players plus a goalie

3 subs are allowed (8 max players per team)

EVERY TEAM NEEDS TO WEAR THE SAME COLOR

$40 per player --includes a T-shirt

Check-in 8:30 a.m.

Registration Deadline: MONDAY, February 23, 2004

SEE ATTACHED REGISTRATION FORM

Each player MUST fill out a registration form

ALL forms must be submitted together with 1 check

Please make check payable to: Kim Ciarrocca, Inc.

REGISTRATION DEADLINE: FEB. 23

For any questions, please contact

Kim Ciarrocca (215)204-6668 or kimlax@unix.temple.edu

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Name:________________________Age:_________

Phone #:_________________

Address:____________________________________________________________

School:_____________________Grade:__________

Email:__________________

TOURNAMENT TEAM NAME AND COLOR__________________________

PLAYERS ON YOUR TEAM_________________________________________

__________________________________________________________________

Temple University Lacrosse 4V4 Clinic

Waiver and Assumption of Risk

___________________________hereby elects to take part in the Temple University Girls Lacrosse 5V5 Clinic.

(participants name)

We acknowledge that this is an extracurricular activity in which our daughter is participating voluntarily and understand that there might be some risk in connection with the activity itself/or the transportation to and from the activity. In consideration of our daughter being permitted to participate in the activity, we hereby assume all of these risks and waive any possible claim that we might have against Temple University, its trustees, employees, agents or students in conjunction with our participation in this activity.

I further acknowlegde that the above named individual is covered by health insurance, the particulars of which are described below.

Date_________

Parent/Guardian Name:__________________________Signature:______________________

Health Insurance Carrier:__________________________

Group/Policy Number:_______________________

EmergancyContact:_____________________________

Telephone #:________________________________

Mail completed forms and checks to:

Kim Ciarrocca, Inc

255 Peoples Way

Hockessin, DE 19707