PRE-SEASON BLAST TOURNAMENT ENTRY FORM Fill Out Completely & Please Print Clearly
TEAM NAME: TEAM CONTACT NAME: ADDRESS: CITY: EMAIL: HOME# FAX# HOME COLOURS: PLAYER NAME 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COACH MANAGER TRAINER
DIVISION:
PROVINCE:
POSTAL CODE:
WORK# CELLULAR# AWAY COLOURS: HIGHEST EXPERIENCE
JERSY NUMBER
I have enclosed $__________ Full payment $__________ Deposit ***Deposit required with registration as confirmation*** **Balance of $800 Entry Fee due by Aug 20th, 2013** Cheques Payable to: Chrissy Degen 3B-240 Westmeadow Dr Kitchener, ON N2N 0A1