btc Las Vegas League -

Please complete the following application for boys team charity, Las Vegas. SPONSOR NOT REQUIRED, LEAVE EMPTY IF YOU DO NOT HAVE ONE.

TeamMate 1 Name (First, Last)

TeamMate 1 High School Graduating Class

TeamMate 1 School Attending in Fall

TeamMate 2 Name (First, Last)

TeamMate 2 High School Graduating Class

TeamMate 2 School Attending in Fall

TeamMate 3 Name (First, Last)

TeamMate 3 High School Graduating Class

TeamMate 3 School Attending in Fall

Primary Parent Name (First, Last)

Primary Parent Email Address

(This is the primary contact for email communication.)

Primary Parent Home #

Primary Parent Cell #

Coach 2 Name (First, Last)

Coach 2 Email Address

Coach 2 Home #

Coach 2 Cell #

Family's Home Address

Family's Home City

Family's Home State

Family's Home Zip Code

Sponsor

Sponsor's Email Address

Sponsor's Phone Number

Type the code from the image