3RD, 4TH, & 5TH GRADES BOYS' AND 3RD & 4TH GIRLS'
2011 JANUARY TOURNAMENTS REGISTRATION FORM

3rd Girl's Rules	4th Girl's Rules
3rd Boy's Rules	4th Boy's Rules	5th Boy's Rules

3rd Girl's Schedule	4th Girl's Schedule
3rd Boy's Schedule	4th Boy's Schedule	5th Boy's Schedule

TEAM REGISTRATION ONLY......$175

REGISTRATION DEADLINE December 15, 2010 3 GAME GUARANTEE

� Boy     � Girl             � 3rd Grade    � 4th Grade    � 5th Grade

Team Name _____________________________ Coach's Name ______________________________ Address __________________________ City, State, Zip ____________________________________ Phone Number H: _________________ W: ____________________ Mobile: ____________________ Fax Number _____________________ Email Address: ______________________________________ ALL CONFIRMATIONS WILL BE MADE VIA EMAIL

Please complete and return this registration form with the $175 non-refundable team fee toTHE GYM of Springfield, 1823 Camp Lincoln Road, Springfield, IL 62707 by December 15, 2010.