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2004 FOX 4 Tournament Registration Form
Event (Circle
One):
April 25th June 13th August 1st
September 26th
Division (Circle One):
Rookie Novice
Entrance Fee:
Rookie: $150 per team
Novice: $200 per team
Team Name: _________________________
Team Roster:
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Captain |
Player 2 |
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Full Name: |
Full Name: |
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Date of Birth: |
Date of Birth: |
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Address: |
Address: |
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City:
State: Zip: |
City:
State: Zip: |
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Phone: |
Phone: |
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Email: |
Email: |
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Player 3 |
Player 4 |
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Full Name: |
Full Name: |
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Date of Birth: |
Date of Birth: |
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Address: |
Address: |
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City:
State: Zip: |
City:
State: Zip: |
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Phone: |
Phone: |
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Email: |
Email: |
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Player 5 |
Player 6 |
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Full Name: |
Full Name: |
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Date of Birth: |
Date of Birth: |
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Address: |
Address: |
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City:
State: Zip: |
City:
State: Zip: |
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Phone: |
Phone: |
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Email: |
Email: |
Payment Method:
Cash
Check (Must be received 10 days prior to registration closing)
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Credit Card: VISA M/C AMEX (Circle appropriate one)
Card Number: _______________________________ Expiration Date:
_____/_____
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* Waivers & Entrance Fee must accompany the Registration Form
* Entrance Fee is non-refundable |