|
|
|
|
|
Tournament___________________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Date ________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Class________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Sanction #____________________________________ |
|
|
|
|
|
|
|
|
|
|
|
Team
Name_______________________________________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
Manager__________________________________________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
Address__________________________________________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
City__________________________________________
State__________ Zip _________________ |
|
|
|
|
|
|
|
|
|
|
|
Home Phone_______________________________
Cell____________________________________ |
|
|
|
|
|
|
|
|
|
|
|
Email_____________________________________________________________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Amount Due__________________________ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Credit Card# |
|
|
|
|
|
Exp |
|
|
Name as it Appears on Card |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Date |
Amount Due |
Amount Paid |
Payment Type |
Balance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MAIL TO:
RIVERSTAR SPORTSPLEX
5993 LINNEMAN STREET
CINCINNATI, OH 45228 |
