3rd Annual Tom Vadas

Memorial Dodge Tourney

TEAM REGISTRATION FORM

EVENT DATE: Saturday May 8^th

TEAM CHECK IN: Youth by 2:30pm, Adult by 6:00 pm

Registration Deadline is: Friday, April 1^ST

($5 per person late fee after deadline)

Instructions:

1. Complete this form

2. Complete a medical form for each participant

3. Pay the entry fee of $100.00/Youth or $30.00 per team member adult division (Max 8 players)

4. Do a team fundraiser (trophy awarded for top fundraising team & team photo in media/website, etc)

Team Name

Team Captain _________________________________Phone________________E-Mail

Division (5^th-8^th grade) Adult (9^th grade –adult):

Adult Division (chose one) Bonzai Division (competitive) Average Joe (non-competitive)

***Both divisions will compete for spirit & fundraising trophies. Average Joe division is not eligible for Dodge for the Cure Championship Trophy (bases on skill ) ***

Player Name Phone #     E-mail           Med Form                Amount Raised

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For more information contact: Sandie Vadas 772-528-3204 jersey-girl1@live.com

or Carrie Oscarson 772-341-9269 oscarson6@comcast.net

Check out: http://dodgeforthecure.com/