Team Name:

Team Representative:

Phone Number:

Email:

Address:

City:

State:

State:

Zip:

Would you like to order Team Uniforms Shirts? Choose One Yes No

Deposit / Full Payment
$50 Deposit is required to reserve your team two weeks prior. 
Full Payment & Roster  is due before start of tournament
Credit Card Information is required to process application. 
Dodgeball director will call or email with confirmation.
Please Call (413) 543-8554 to put Balance on Credit Card.