Team Name:

Team Representative:

          Phone Number:

                        Email:

                   Address:

                        City:

                      State:

                        Zip:

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

                Deposit / Full Payment
                             A $50.00 deposit is required to reserve your team, so let us know as soon as you can. 
                      Full Payment & Roster is due before you can compete in the tournament. 
                         Dave will call or e-mail with confirmation.
                        Please call (413) 543-8554 to put balance on credit card.