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PRINT THIS FORM OUT AND FAX: 212-338-9677

Individual Player ENTRY FORM

Last Name: _______________________________________________________

First Name: _______________________________________________________

E-Mail: ___________________________________________________________

Work Telephone: (______)___________________________________________

Home Telephone: (______)__________________________________________

Mobile: (______)___________________________________________________

New Team Name: __________________________________________________


The season will begin Sept 7, 2004. Please fill out this form completely and have check or cash ready in the amount of $100.00 made out to Worldwide Basketball League . (Don't forget to include your daytime phone number on the check). Once you get on a team you have to log on to our website, therunwbl.com, you can also pay by credit card, call 212 490-2197 All team members must sign the Waiver Form.

 

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