Team Captain Name *

First Name

Last Name

Phone *

(###)

###

####

Today's Date *

We go on a first come, first serve basis

MM

DD

YYYY

Your Address *

This is so we know which cities all the teams are coming from.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Registration Division *

Elite Division (Open A)

Over 40 A

Gold (B Division)

Silver (C Division)

Bronze (D Division)