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PRINT THIS FORM AND FAX: 212-338-9677

 

The season will begin Sept 7, 2004. It will consist of 2 Scrimmage, 10 Games and Playoffs. The entry fee is $1,000.00 per team and includes 10 T-Shirts, Court and Referee Fees. All team members must fill out an individual form. All team members must sign the Waiver Form.

1. ___________________________  6. ________________________________
2. ___________________________  7. ________________________________
3. ___________________________  8. ________________________________
4. ___________________________  9. ________________________________
5. ___________________________  10.________________________________
(Please print the names of individuals on your team on the lines above)


TEAM NAME ____________________________

TEAM CAPTAIN__________________________

E-Mail: ________________________________

CAPTAIN'S ADDRESS __________________________________________________

________________________________ ZIP ______________

Telephone:
Office: (_____)________________________
Home: (______)_______________________
FAX: ______________________________________

 

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© 2004 Worldwide Basketball League - WBL