Home Please take a moment to let us know who you are; we will follow up shortly with a 2024 membership agreement form. You’ll submit that and receive an auto reply email that will contain the link to request your Certificate of Insurance (COI) for 2024.All fields required unless otherwise indicated. Name of Organization Are you a: League Program Team Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon USA Lacrosse Region that you are in: - Select -Mid AtlanticMidwestMountainNew EnglandNorth AtlanticNortheastPacific NorthwestPacific SouthwestSoutheastSouthwest Primary Contact Name Primary Contact First Name* Primary Contact Last Name* Primary Contact Email Primary Contact Phone Select one: Yes, we are a full member organization and require that all of our players and coaches be current members of USA Lacrosse during the duration of our season or activity period. No, we are not a full member program but are interested in speaking with a Regional Manager to learn more. CAPTCHA Math question 15 + 4 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This is required for testing whether or not you are a human visitor and to prevent automated spam submissions.
Please take a moment to let us know who you are; we will follow up shortly with a 2024 membership agreement form. You’ll submit that and receive an auto reply email that will contain the link to request your Certificate of Insurance (COI) for 2024.All fields required unless otherwise indicated. Name of Organization Are you a: League Program Team Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon USA Lacrosse Region that you are in: - Select -Mid AtlanticMidwestMountainNew EnglandNorth AtlanticNortheastPacific NorthwestPacific SouthwestSoutheastSouthwest Primary Contact Name Primary Contact First Name* Primary Contact Last Name* Primary Contact Email Primary Contact Phone Select one: Yes, we are a full member organization and require that all of our players and coaches be current members of USA Lacrosse during the duration of our season or activity period. No, we are not a full member program but are interested in speaking with a Regional Manager to learn more. CAPTCHA Math question 15 + 4 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This is required for testing whether or not you are a human visitor and to prevent automated spam submissions.
