| Team Name:______________________________ |
Division: L.L. J.V. Var.
(circle one) |
Church
Name:_____________________ |
| Coach's
Name:____________________________ |
Phone # ( )___________________ |
|
|
Address:____________________________ |
City
________________________________________ |
Zip___________ |
| e-Mail
Address:___________________________ |
State_________ |
|
|
TEAM MEMBERS |
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| |
Name for |
|
|
#Years of |
Birthdate/ |
| Quizzer's Name |
Name Tag |
Phone # |
Address |
Experience |
e-Mail |
| 1.____________________________ |
_________________ |
( )
__________________ |
___________________________________ |
_________ |
_______________________ |
| |
|
Grade
__________________ |
___________________________________ |
e-Mail Address => |
_______________________ |
| 2.____________________________ |
_________________ |
( )
__________________ |
___________________________________ |
_________ |
_______________________ |
| |
|
Grade
__________________ |
___________________________________ |
e-Mail Address => |
_______________________ |
| 3.____________________________ |
_________________ |
( )
__________________ |
___________________________________ |
_________ |
_______________________ |
| |
|
Grade
__________________ |
___________________________________ |
e-Mail Address => |
_______________________ |
| 4.____________________________ |
_________________ |
( )
__________________ |
___________________________________ |
_________ |
_______________________ |
| |
|
Grade
__________________ |
___________________________________ |
e-Mail Address => |
_______________________ |
| 5.____________________________ |
_________________ |
( )
__________________ |
___________________________________ |
_________ |
_______________________ |
| |
|
Grade
__________________ |
___________________________________ |
e-Mail Address => |
_______________________ |
| |
|
|
|
|
|
| Please
fill out this form completely and neatly!! |
|
Fees: $12 per experienced quizzer. |
Registration Total $ ______________ |
| Send
registration forms, as soon as possible, to: |
Roberta Hinz |
Please make checks payable to: James Murphy |
Please send with a copy of the
registration to: |
|
262 Harrison Street |
Phone (734) 475-7810 |
PO Box 595, Lakeland, MI 49143 |
|
Chelsea, MI 48118 |
Fax (734) 995-0377 |
|
| If
electronically send to robertahinz@hotmail.com and jmurphy@chartermi.net |
NOTE: Please verify spelling
of quizzer's name |
|
| Please feel
free to copy and distribute this form to other interested parties. |
|
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