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2009
COLORADO STATE CHAMPIONSHIP GAMES
REGISTRATION
Print and complete form,
mail it to NABA National headquarters at 3609 S. Wadsworth Blvd., Suite
135, Lakewood, Colorado 80235 or Fax it to- 303.639.6605
Be sure to include
your deposit.
Manager’s
Name ___________________________________
Player’s
Name___________________________________ _
Address
_______________________________________________
City
__________________________ ST _____ Zip _______
Day
Phone (______)_____________ Home Phone (____)_____________
NABA
League______________________ Email:____________________
League
President ____________________________________________
Team
Name__________________________________________
Please check only one: ____ Complete team. ___ Partial team.
__ Individual player pool player
I/We
plan participate in the following division: _ _18AAA, __18AA,
__18A, __18R, __25R, __35R, __45R
I/We have enclosed a deposit in the amount of: _____ $500 (Team)
Deposit submitted is made by:
______
Certified funds or money order ________ Visa ________ Master card
_________AMEX
Amount Authorized $_____________ Expiration Date __________
Credit Card Number ________________________________
Card
Holders Signature____________________________ Date ________
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