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BORICUA CLASSIC TOURNAMENT REGISTRATION
Complete form, detach
this portion of the brochure and mail it to NABA
National headquarters at 3609 S. Wadsworth Blvd., Suite
135, Lakewood, Colorado 80235. Be sure to include
your deposit.
Or send this information
with your credit card information to NABANational@aol.com.
Manager’s Name
___________________________________________ Player’s
Name ____________________________________________
Address
____________________________________________________
City _____________________________ ST _____ Zip
__________
Day Phone
(______)________________ Home Phone
(______)_________________ NABA League
_________________________________
League President
_______________________________________ Team Name
__________________________________________________
I/We plan participate in
the following division: ____18AA ____18R ____ 25R ____
35R
I/We have enclosed a
deposit in the amount of: _____________ (write in amount
if different than $350) or an amount of $350 (Team)
_______
Deposit submitted is made
by: __________ Certified funds or money order __________
Visa __________ Master card ___________AMEX
Deposit submitted is made
by: __________ Certified funds or money order __________
Visa __________ Master card ___________AMEX
Amount Authorized
$_____________ Expiration Date ______________ Security
Number _________________________________________
Name on Card
________________________________ Billing Address
________________________________________________________
Credit Card Number
_________________________________________________________________________________________________
Card Holders Signature
______________________________________________________________
Date ____________________________
(By signing this card
holder signature form you are verifying that you are the
card holder of the credit card being used in this
transaction. Furthermore, you agree to allow the NABA
to use your credit card for the amount authorized by you
in the above registration for services rendered by NABA.)
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