PALM SPRINGS WINTER CLASSIC 2012

ATTN: Vicki Oltean

401 S. Pavilion Way w Palm Springs, CA 92262

Telephone: (760) 323-8277 w FAX: (760) 323-8279

WINTER CLASSIC '12

ENTRY FORM  (due January 20, 2012)

Team: _____________________________________________________________

                              

Sponsor:___________________________________________________

A.S.A. Registered Team Name:_________________________________

Team Website Address:_______________________________________

League Name / City:__________________________________________

Team Coach / Manager:_______________________________________

Mailing Address:_____________________________________________

___________________________________________________________

Email Address:______________________________________________

Phone Number:_____________________________________________

Best time to call:_______________________________

FAX Number:__________________________________

Alternate Team Contact:______________________________________

Phone Number:________________________________

Best time to call:_______________________________

Division Entered:______________________________

For more information on Winter Classic '12, contact Vicki Oltean at: (760) 323-8277