MetroLacrosse Visit Request

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If you would like to set up a MetroLacrosse visit at your school, camp, or community center, please fill out the information below. You will be contacted by MetroLacrosse to confirm your request.

All fields marked with an asterisk (*) are required.

Contact Information

Name of Organization *

Contact Person *

Phone Number *

Secondary Contact Person *

Secondary Contact Phone Number *

Email Address *

email@domain.com

Street Address *

Neighborhood *

Other Neighborhood *

State *

Zip Code

Type of programming requested * Clinic - instructional, hands-on lacrosse session
Informational Meeting - description of MetroLacrosse's programs, including video
Other - please specify

Other type of programming *

Grade Range

*From

Grade of youngest participants

*to

Grade of oldest participants

Dates requested

Please select one of the following: *
One-time Visit
Recurring Visit
Multiple Dates

Date *

Time *

Duration *

45 minutes, 1.5 hours, etc.

Initial Date *

Time *

Duration *

45 minutes, 1.5 hours, etc.

Frequency *

Every Wednesday for 4 weeks, Every other Tuesday, etc.

Date *

Time *

Duration *

45 minutes, 1.5 hours, etc.

Date *

Time *

Duration *

45 minutes, 1.5 hours, etc.

Add more dates

How did you hear about MetroLacrosse?

Additional Notes/Comments

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