Week 2 Aug 22nd to 26th
Any comments or questions
Full details of course
Printable version of this form
Date of birth
Email address please
Highest playing experience
Please confirm the days in week 2 that you will be available for mentoring and testing.
Medical conditions and/or medications
Receipt of form and of payment will be made as swiftly as possible by email or phone if no email address is given
The level 2 coaching course with a week’s mentoring and testing - £240.
Please send a cheque payable to ‘Chiswick Lacrosse’ to Chris Southwell, Bryn Deri, Haverfordwest, Pembrokeshire, SA62 6ND
or pay by transfer to: Midland Bank - Chiswick Lacrosse - Sort Code: 40-44-39 - account number - 81635638 please quote your name as reference.
I wish to do the level 2 coaching course. Sat 20th Aug 9.30 to 5.30 & Sun 21st Aug 9.30 to 5.30 (Cost £240 incl mentoring)
Mon Aug 22nd
Tue Aug 23rd
Wed Aug 24th
Fri Aug 26th
ELA membership number
Click to register
Application form for Lacrosse Coaching Level 2 2016
Sat 20th and Sun 21st Aug
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