REGISTRATION FORM

KALAMAZOO NIT REGISTRATION FORM
Register online at http:/www.usssa.com
OR
Print and return with TEAM RANKING form to:
Dan Perrin
8726 Portage Rd.
Kalamazoo, MI 49002

Team Name: ____________________________________________

Age Division (circle one): 11U 12U 13 U 14U 15U 16U 18U

Team Classification (circle one): Major   or   AAA

Manager's Name: _________________________________________

Coach's Name: ___________________________________________

Manager's Address: _______________________________________

City: _________________________________   State:______________ Zip: ______________

Home Phone:(_____)__________ Work Phone:(_____)___________ Fax:(_____)__________

E-Mail: _________________________________________________

OFFICE USE ONLY

Receipt #: ________________ Amount Paid: ____________ Registration Fee: ______________

Date: ____________________ By: __________________________________