2013 US Lacrosse North East Regional Championship
Housing Form

PRICING: Double Rooms = $28 per person Single Rooms = $32 per person *2 chaperone/coaches of the same gender are required to stay with the team in the dorms. **Meal options onsite at the university cafeteria are available and will be emailed to teams.

Team Name

Boys or Girls

- Select - Boys Girls

Age Group

-Select- U11 U13 U15

Team Contact Person

Team Contact Telephone Number: (xxx-xxx-xxxx)

Team Contact Email:

Check-In Date:	Thursday, June 20, 2013 Friday, June 21, 2013

Dorm rooms will have two single beds. Please indicate individuals sharing a room. All requests will be considered on a space available basis All Rooms are blocked on a first come first serve basis Each team has a limit of 24 players and a requirment of 4 coaches/chaperones.

Room 1

Athlete 1

Athlete 2

Room 2

Athlete 3

Athlete 4

Room 3

Athlete 5

Athlete 6

Room 4

Athlete 7

Athlete 8

Room 5

Athlete 9

Athlete 10

Room 6

Athlete 11

Athlete 12

Room 7

Athlete 13

Athlete 14

Room 8

Athlete 15

Athlete 16

Room 9

Athlete 17

Athlete 18

Room 10

Athlete 19

Athlete 20

Room 11

Athlete 21

Athlete 22

Room 12

Athlete 23

Athlete 24

Room 13

Chaperone/Coach 1

Chaperone/Coach 2

Room 14

Chaperone/Coach 3

Chaperone/Coach 4

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