6th ANNUAL ALEX BENNETT MEMORIAL 3-ON-3 BASKETBALL TOURNAMENT
Registration Form

   
All registrations must be received no later than October 28, 2009.
   
Team registration fee $65 (Checks payable to: Alex Bennett Memorial Tournament)  
Mail Checks to:
Steve Irion
3525 Ridge Drive
Grand Junction, Colorado, 81506
phone: (970) 248-4829
   
   
Team Name
   

   
  Team Roster 4 players per team (minimum of 3)        
Team Member # 1 
Grade 
  
Team Member # 2 
Grade 
  
Team Member # 3  
Grade 
  
Team Member # 4  
Grade 
  
Age Division 
       
Team Contact: Name 
        
Address  
        
City 
State 
Zip 
Phone 
E-mail 
 
  

I hereby certify that the members of the above named team are eligible to compete in the 6th ANNUAL ALEX BENNETT MEMORIAL 3-ON-3 BASKETBALL TOURNAMENT according to the rules and regulations stipulated by Mesa County Junior Basketball Association and that each player is covered by a proper accident policy of insurance. In consideration of your accepting this team roster, I hereby, for myself, my team, their personal representatives, heirs and assigns, waive and release any and all rights and claims for damages I may have against the Association for any injury or damage incurred at the tournament.

       
Name of person submitting this form  
Date