To assure your space at the Wings Lacrosse Camp, please print this page and fill out the application information and send it with a $100 deposit check (non-refundable) made payable to Jake Bergey's Wings Lacrosse Camp . Tuition must be paid in full by July 1st. When your registration form is received, you will be sent a confirmation letter or email with all necessary camp information.

REGISTRATION IS NOW CLOSED

Please fill out and print. When completed, please mail to: P.O. Box 2537 West Chester, PA 19380 *Also include $100 Deposit

Name:

Address:

City:

State:

Zip Code:

E-Mail Address:

Phone Number:

Age as of July 1st, 2008:

School/Team:

Years of Experience:

Roommate Request:

Position:

US Lax Number (if applicable)

July 14th - July 18th, 2008

$450 Resident Camper

$350 Day Camper (8:30 am - 9:00 pm includes lunch and dinner)

$20 Family Discount Per Camper (2 or more family members)