Name of Organization:

_____________________________________________________

Address:

City:

_____________________________________________________

______________ State:_____________ Zip Code:_______

Team Name:

_____________________________________________________

Head Coach:

_____________________________________________________

Home Phone:

Work Phone:

Fax :

Email:

Assistant Coach(s):

 Grades (Circle)

(___)________________________________________________

(___)________________________________________________

(___)________________________________________________

 ____________________________________________________

 ____________________________________________________

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Boys -  3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th, 12th Challenge 

Series Members	First Time Participants
Early Registration $250 Per Team (Now to 10/15) $200 for 2 or more teams  Regular Registration $300 Per Team (10/15 to 11/7) $250 for 2 or more teams	Early Registration  $275 (Now to 10/15) $225 for 2 or more teams Regular Registration  $350 (10/15 to 11/7) $300 for 2 or more teams