Club Interest Form - Trilogy Lacrosse

Which Trilogy club team is the player below applying for or being recommended for? *

NJ Diesel NJ Sixers (box)

Player Name (First & Last) *

Player Position *

High School Grad Year (XXXX) *

Parent First Name *

Parent Last Name *

Parent Email *

Parent Phone *

City *

State (ex. NY, GA) *

Please be sure to include your (or your coach's) name, email & phone number so we can follow up if we have any questions...

Who is filling this form out? Be sure to include your name, email, phone number and relationship to the player (ex. Rec Coach, Parent, etc) *