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Posted July 13th, 2009

 

 

 

July 18th and 19th:

Team Name:

 

Division entered:

Men's:

  

Old Boys:

  

Women's:

  

Boys' U19:

  

Individual Player:

  

Club/Team Contact:

Name:

 

Address:

 

Phone[s]:

 

E-mail address:

 

Individual Player Contact:

Name:

 

Address:

 

Phone[s]:

 

E-mail address:

 

Entry Fee: 

______  $ 250.00 per Men's Club  |  ______  $ 80.00 per Women's Club and U19 Team

______  $   10.00 per Women's and U19 Individual Player entry

Total enclosed:  ____________

Make checks payable to:  Fort Wayne Rugby Football Club

Mail your Registration Form and checks to:

Three Rivers, c/o Matthew A. Doss, 225 N. Haflich St., Markle, IN 46770

 

For questions on the Men's Tournament and the Women's match please contact Mathew Doss, (W) 260-758-2111

For questions, and/or registration in the U19 Tournament please contact Randy Harding, (C) 260-402-5315