2017 Dodge Drugs Team Registration
Teams should consist of 6 people
Team Name
Your answer
List individual team member names
Your answer
Affiliated organization if applicable
Your answer
Contact person for the team
Your answer
Email address for contact person
Your answer
Phone number for contact person
Your answer
Will this team be participating in the youth or adult division of the dodgeball tournament?
Cost: $30 per team of 6
Team registration fee can be paid by mail or at the door on the day of the event. Payment can be sent to Prevention Means Progress at 515 E Broadway, Council Bluffs, IA, 51503. Please make checks payable to Heartland Family Service.

There is a $1 admission fee for those who just want to watch the fun! This will be collected at the door on the day of the event.

All individuals participating on a dodgeball team must sign a release on the day of the event before playing. Individuals under the age of 18 must have a parent signature.
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