West bloomfield West bloomfield
T-SHIRT: (circle one) YOUTH / ADULT
ALEXANDER&GABRIELLE
MANSOUR MEMORIAL FUND
SIZE: (circle one) S / M / L / XL / XXL
TEAM NAME: PLAYER NAME: DATE OF BIRTH: ADDRESS: CELL PHONE: EMAIL ADDRESS: EMERGENCY CONTACT: CELL PHONE:
benefiting
West bloomfield
school district
LIABILITY DISCLAIMER I understand that all activities I participate in relating to this basketball event on June 14, 2014 at West Bloomfield High School are done at my own risk and I accept full responsibility. I agree not to bring any claim against the organizers of this basketball event or anyone entity, individual, or organization hosting the event. I have read and accept the terms of this liability disclaimer form. Participant Name Participant Signature Date PARTICIPANTS UNDER 18 Parent/Guardian Name
Parent/Guardian Signature
Date
team costs
120 AGES 8-16 $
180 AGES 17+
$
SATURDAY, JUNE 14 WEST BLOOMFIELD HIGH SCHOOL 50/50 RAFFLE food / refreshments special guest: Hooper at the kids tournament! WWW.ALEXANDGABBY.COM
ALEXANDER&GABRIELLE ALEXANDER&GABRIELLE MANSOUR MEMORIAL FUND
MANSOUR MEMORIAL FUND
office use only:
SATURDAY JUNE 14 WEST BLOOMFIELD
Received by: Date: Payment Type: Check / Cash Payment Amt:
HIGH SCHOOL MISSION
The Alexander and Gabrielle Mansour Memorial Fund of the Community Foundation for Southeast Michigan will be a permanently endowed fund to support the West Bloomfield School District. MAKE CHECKS PAYABLE TO:
Community Foundation for Southeast Michigan and write “Alexander & Gabrielle Mansour” in the memo MAIL OR DROP OFF ATTACHED FORM TO YOUR SCHOOL OFFICE CO-ED TOURNAMENT - AGES 8-10 BOYS & GIRLS TOURNAMENT - AGES 11-13, 14-16 Fee: $120/team $30/person for 4 player teams, $40/person for 3 player teams Registration: 8:00 am | Game Time: 9:00 am
MEN & WOMEN TOURNAMENT - AGES 17+
FOR MORE INFORMATION CONTACT:
JOHN MANSOUR Phone: 248.425.3993 Email: [email protected]
Fee: $180/Team $45/person for 4 player teams, $60/person for 3 player teams Registration: 1:00 pm | Game Time: 2:00 pm
**AGES AS OF JUNE 14,2014**
All players must have signed waiver in order to participate. Limited teams available. Must be registered by April 4, 2014
Check Number:
TEAM NAME: PLAYER NAME: AGE BRACKET: q Co-ed Only 8-10 q 11-13 q 14-16 q 17+
GENDER: q MALE q FEMALE
CELL PHONE: EMAIL ADDRESS: PLAYER 2: PLAYER 3: PLAYER 4:
ALEXANDER&GABRIELLE
MANSOUR MEMORIAL FUND
SIZE: (circle one) S / M / L / XL / XXL
TEAM NAME: PLAYER NAME: DATE OF BIRTH: ADDRESS: CELL PHONE: EMAIL ADDRESS: EMERGENCY CONTACT: CELL PHONE:
benefiting
West bloomfield
school district
LIABILITY DISCLAIMER I understand that all activities I participate in relating to this basketball event on June 14, 2014 at West Bloomfield High School are done at my own risk and I accept full responsibility. I agree not to bring any claim against the organizers of this basketball event or anyone entity, individual, or organization hosting the event. I have read and accept the terms of this liability disclaimer form. Participant Name Participant Signature Date PARTICIPANTS UNDER 18 Parent/Guardian Name
Parent/Guardian Signature
Date
team costs
120 AGES 8-16 $
180 AGES 17+
$
SATURDAY, JUNE 14 WEST BLOOMFIELD HIGH SCHOOL 50/50 RAFFLE food / refreshments special guest: Hooper at the kids tournament! WWW.ALEXANDGABBY.COM
ALEXANDER&GABRIELLE ALEXANDER&GABRIELLE MANSOUR MEMORIAL FUND
MANSOUR MEMORIAL FUND
office use only:
SATURDAY JUNE 14 WEST BLOOMFIELD
Received by: Date: Payment Type: Check / Cash Payment Amt:
HIGH SCHOOL MISSION
The Alexander and Gabrielle Mansour Memorial Fund of the Community Foundation for Southeast Michigan will be a permanently endowed fund to support the West Bloomfield School District. MAKE CHECKS PAYABLE TO:
Community Foundation for Southeast Michigan and write “Alexander & Gabrielle Mansour” in the memo MAIL OR DROP OFF ATTACHED FORM TO YOUR SCHOOL OFFICE CO-ED TOURNAMENT - AGES 8-10 BOYS & GIRLS TOURNAMENT - AGES 11-13, 14-16 Fee: $120/team $30/person for 4 player teams, $40/person for 3 player teams Registration: 8:00 am | Game Time: 9:00 am
MEN & WOMEN TOURNAMENT - AGES 17+
FOR MORE INFORMATION CONTACT:
JOHN MANSOUR Phone: 248.425.3993 Email: [email protected]
Fee: $180/Team $45/person for 4 player teams, $60/person for 3 player teams Registration: 1:00 pm | Game Time: 2:00 pm
**AGES AS OF JUNE 14,2014**
All players must have signed waiver in order to participate. Limited teams available. Must be registered by April 4, 2014
Check Number:
TEAM NAME: PLAYER NAME: AGE BRACKET: q Co-ed Only 8-10 q 11-13 q 14-16 q 17+
GENDER: q MALE q FEMALE
CELL PHONE: EMAIL ADDRESS: PLAYER 2: PLAYER 3: PLAYER 4:
