NWA Invitational Registration Form
PLEASE FILL OUT ALL FIELDS:
Team Name:
Head Coach:
Address:
City:
State:
Contact Number:
Email Address:
__________________________________________________________________________________________________
In consideration of being allowed to participate: I, the undersigned representative of above listed team, waive all claims for injury, accident, or loss of any kind and hereby release Arkansas Blazers and all associated gymnasiums, their employees, members and representatives from any claims. In addition, I verify that all information contained on this form is accurate. I Agree:
Division:
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
High School
Male
Female
Competitive Level:
1
2
3
4
5
6
7
8
9
10
**Will be used only in events with enough teams for A,B and possibly C pools to divide competition levels evenly.
SPECIAL REQUESTS: (WE WILL ATTEMPT TO HONOR ANY SPECIAL REQUESTS FOR SCHEDULING. WE CANNOT GUARANTEE THAT THEY CAN ALWAYS BE MET, BUT WE WILL TRY.) PLEASE LIST BELOW:
Number of Players on your Roster:
5
6
7
8
9
10
11
12
13
14
15
Instructions: Submit your registration information by clicking on the "Send" button below; to register another team or start over, click on the "Reset" button. After submitting your registration for your team(s), you will be sent a PayPal request for payment(s) within 24 hours. Thank you for particapating in our event.