Registration | Immokalee Venom Lacrosse Club

Please read these instructions COMPLETELY before proceeding to the registration.

If you have an existing Immokalee Venom account LOGIN BEFORE GOING ANY FURTHER! Then come back to this registration.

This registration session will allow you to complete contact information, enter USLacrosse membership information, sign up for participation and submit payment via PayPal. To complete registration through our secure site, please have your USLacrosse member number and your Visa, MasterCard, Discover, or checking account information available. Following the completion of this registration, you will see a charge on your account.

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Username^*

Password^*

Password must be at least 7 characters long.

Enter password again^*

Password must be at least 7 characters long.

Email^*

Enter email again^*

Guardian First Name^*

Guardian Last Name^*

Address

Address Line 1

Address Line 2

City

State or Region

Country

Zip

Player Name^*

Player Email^*

Player Date of Birth^*

USLacrosse Number

Player Jersey Size^*

Fall Registration Fee

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