Rates:-2 days £110, 3 Days £130, 4 Days £150, 5 days £160, Further days £20 extra per day
If you are paying by cheque please make it payable to: ‘Chiswick Lacrosse’ and send it to:
Chris Southwell, Bryn Deri, Haverfordwest, Pembrokeshire, SA62 6ND
Alternatively if you wish to pay using Internet Banking please set up payment to:
HSBC Bank - Chiswick Lacrosse - Sort Code: 40-44-39 - account number - 81635638
Do quote your Daughter’s name in the reference
Check box if you would like your daughter to have an Opro mouthguard fitting 22nd and 29th Aug. Please read note in full details
Please indicate each day your daughter is attending by checking the boxes
Week 1 Aug 13th to 17th
Week 2 Aug 20th to 24th
Week 3 Aug 27th (Bank holiday) to 30th
Date of birth
Email address please
Highest playing experience
Does your daughter have a Lacrosse stick ?
We do have some for borrowing.
Cost for number of days (see below)
Total amount to pay
Going Home arrangements arrangements
Any other comments
Please indicate how you wish to pay:
Mon (Bank holiday)
My daughter may play without goggles
I will provide goggles for my daughter to wear
Please indicate your preference for your daughter regarding wearing of goggle. Click here for my comments
Is your daughter applying as part of a squad?
Medical conditions and/or medications
New school if starting next September
Plus £5 Annual membership fee.click here for full details
We will reply as soon as we can.
Please note we have never had to refuse an application. We have plenty of pitches and about 50 staff to call on.
Online Application form for Girls Lacrosse Camp 2018
Use Tab key to move through the form