JJuly 9th & 10th 2011. Juan de Fuca Rec Centre, 1767 Island Highway, Victoria BC, 250-478-8384
 
Registration Form
Registration Deadline: July 3rd, 2011- 5:00pm!
 
Team Name:_______________________________
 
Players:
1.(Captain)
 ____________________________________ Phone: __________________
Shirt Size:    Md     Lg    XL
 Email:  _____________________
2.
 ____________________________________ Phone: __________________
Shirt Size:    Md     Lg    XL
  
3.
 ____________________________________ Phone: __________________
 
Shirt Size:    Md     Lg    XL
  
4.
 ____________________________________ Phone: __________________
 
Shirt Size:    Md     Lg    XL
  
5.
 ____________________________________ Phone: __________________
 
Shirt Size:    Md     Lg    XL
  
 
 
Division:            _____  U13      _____  U18        _____  Open      _____ Over 30       
 
Team Registration Fee: U13 ($20), U18 ($50,) Open ($80,) Over 30 ($80)
Cheques Payable To:
Paul Valentine Memorial Fund
Deliver registration & payment to: Juan de Fuca Recreation Centre, 1767 Island Highway or
Surface Boardshop at West Shore Town Centre

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