Infiterra Sports - Registration Form

THIS FORM MUST NOT BE SENT BEFORE DECEMBER 8th 2005. MAIL IN FORMS WILL NOT BE ACCEPTED IF THE POST MARK DATE IS BEFORE DECEMBER 8th, 2005.

Please fill out this form by typing in the designated fields and choosing from the drop boxes. Then mail this form with your check for the full team payment ($1800) to Infiterra Sports, 1033 Kingston Ave, Flint, MI 48507 Entry must be mailed by April 21st.

EACH TEAM MEMBER MUST FILL OUT THE SAME APPLICATION & SUBMIT THEIR PAYMENT TOGETHER.
ALL INFORMATION WILL BE NEEDED TO PROCESS YOUR APPLICATION.

Team Name:
Team Cell Phone #:
1st Team Mate Name:Phone #:
Address:Shirt Size:
City:State:Zip:
E-Mail Address:
2nd Team Mate Name:Phone #:
Address:Shirt Size:
City:State:Zip:
E-Mail Address:
3rd Team Mate Name:Phone #:
Address:Shirt Size:
City:State:Zip:
E-Mail Address:
4th Team Mate Name:Phone #:
Address:Shirt Size:
City:State:Zip:
E-Mail Address:
Team Entry Fee

* $1800.00 per team