REGISTRATION FORM

Every team must print and fill out this roster and turn it in with the waiver's at the time of paying entry fee.
You must have a waiver filled out for each person on the roster. You can e-mail, fax or mail entry form. Fax to 281-464-9746



TEAM

Team Name:

Team Captain:

Address:

City,State,Zip:

Contact Phone:                                                                                                                                     Alternate Phone:

---TEAM ROSTER---

1. Name, Birth Date:

2. Name, Birth Date:

3. Name, Birth Date:

4. Name, Birth Date:

5. Name, Birth Date:

6. Name, Birth Date:

7. Name, Birth Date:

8. Name, Birth Date:

---PAYMENT INFO---

Division: $250                                                                                               

Payment (circle one): Visa / Mastercard / AMEX / Cash / Paypal

Credit Card holder name as it appears on card:

Credit Card Number:                                                                                                                              Expiration Date: