CT Breeze Tournaments 2011

Registration Form for June 11th and 12th

Club Name:__________________________Team Name:_______________________

           Club AAU #:_____________________ GRADE of Team:__________A____B____C____

   Contact Person:_________________________Email Address:________________________
  Address:____________________________________________________________________
  Phone: ___________________________ Fax: _____________________________________
  Coach:__________________________
Assistant Coach:_____________________
  Team Colors:
_________________________________________________________

            Registration Fee: $425.00       

                Please mail check payable to:
                
CT Breeze: ATTN Doug Shaw, 628 East Main Street, Branford, CT.  06405

Uniform #

Name

Age

AAU #

       
       
       
       
       
       
       
       
       
       
       
       
       
       

Phone number  1-203-494-8510  Fax Number: 203-481-9363