Create a New US Lacrosse Certificate

There was a problem with your submission.

Errors have been highlighted below.

We are currently working on a new system for Certificates. It is important to note that at that time you will be required to enter either your US Lacrosse Member # or the US Lacrosse Group ID. If you do not have a group id, please visit www.USLacrosse.org/program-leaders/getting-started and set up your organization.

Your Information

Please enter your information below.

Certificate for:
Important Note: Coaches must be registered as such in the appropriate category for coverage to apply.
Certificate is for: Team or League Requiring 100% Membership for players and coach members
Camp, Clinic or Tournament with 100% US Lacrosse Membership for players and coach members
US Lacrosse Chapter Event players and coach members
Coaches/Officials/Assignor Association with 100% Lacrosse Members
Choose a Policy Period 1/1/2019 to 1/1/2020
1/1/2020 to 1/1/2021
Organization/Event Name:

Your Name
Your E-mail
E-mail confirmation
Your Phone
US Lacrosse Member # or US Lacrosse Group ID #
Lookup US Lacrosse Member #
Lookup US Lacrosse Group ID #

Your Address
Your Address 2
Your City
Your State
Your Zip Code

Create a New US Lacrosse Certificate

There was a problem with your submission.

Your Information

Toll Free:

Fax: