NAME: _________________________________________________________ COMPANY:______________________________________________________ PHONE:______________________________ FAX:_________________________________ EMAIL:_______________________________ Total Payment Amount $_________________ ($100.00 per player)
Payment Options: You may send one check for all players but please fill out a separate registration form for each player or each team. Please mail this, with your check or credit card information to:
Keep a copy of this before you mail it for your records. Questions call Charles Dixon at 512.499.4903. |