Lacrosse with Coach Brian Balocki
Fall 2021 Registration
Please complete the online registration form below.
A spot is not guaranteed until payment is received and is successfully processed.
$180 - Please pay by Venmo or Check
Refunds are available minus a processing fee of $50. After Aug 15, no refunds available.
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Parental Release: We (I) hereby request that you accept the application of my child in Balocki Athletics, LLC (DBA Atlanta LAX Club) during the dates set forth in this application. In consideration of your acceptance of the application, we (I) hereby release Balocki Athletics, LLC (DBA Atlanta LAX Club) and Trinity School and all their employees for any claims and liability of any nature on account of any injuries which may be sustained by our (my) child while attending The Atlanta LAX Club. We (I) agree to release from liability, hold harmless and indemnify the Atlanta LAX Club, and their employees for any claim which may hereafter be presented by our (my) child as a result of any such injuries. Furthermore, we (I) certify that, within the past year my child has had a physical examination and is physically able to participate in sports activities. In the event of illness or injury, we (I) give consent for medical treatment and permission to the attending physician to hospitalize, secure proper treatment, and order injection, anesthesia, or surgery necessary to render or obtain emergency medical treatment in our (my) children's best interest. Primary insurance is that of the family and SECONDARY insurance is that of the Balocki Athletics, LLC.
I agree to the above
I do not agree
You must agree to the release in order to register for Atlanta LAX Club
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Address, City, State, Zip
Volunteer Coaches/Helpers Needed. If you'd be willing to lend your coaching skills or help otherwise, please check the box.
Yes I'm interested in volunteering
Payment (after submitting registration, you will be taken to the payment page)
After submitting registration, you will be taken to payment page.
Atlanta LAX Club - Balocki Athletics, LLC