2019 Northumberland Nemesis Lacrosse Clash Tournament Application

Please print out and complete this form. You can either scan it (or take a photo of it) and email it to Ken Withers at ken@canadianhomeimprovements.com or mail it (along with your cheque) to:
Northumberland Nemesis
2 Haymur Street
Cobourg, ON
K9A 4V3
We will contact you to confirm your acceptance into the tournament once your application and cheque have been processed.

2019 NORTHUMBERLAND NEMESIS LACROSSE CLASH TOURNAMENT

APPLICATION

Association:  _________________________________
OLA Ranking:  _______________________________
Team:  _______________________________________
Division:  Tyke C/D _____
                   Novice C/D _____
Contact information
Manager  name: ____________________________
Manager phone number: ___________________
Manager email: _____________________________
Head coach name: _________________________
Head coach phone number: _______________
Head coach email: _________________________

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