Please print this form, fill it out, and then mail it to address below!

Date:  April 18th, 2009

Team Name:

Division Entered:

Men's:

Women's:

Jersey Colors:

Contact Name:

Address:

Phone:

(H)

(W-C)

E-mail:

Entry Fee:

  ______  $ 275.00 per Team  |  ______  $ 300.00 per Team if Registration is sent after the 28th of February

  Total enclosed:  ____________  |  Registration Form and Entry Fee Deadline:  March 31st, 2009

Make Check Payable to:

  NIU Men's Rugby

Mail your Registration Form and Entry Fee/Check, by the 31st of March, to:

NIU Men's Rugby

c/o Al Collins, 1111 Spiros Court #8, DeKalb, IL 60115

Check #:

Date:

Amount:

Authorized by:

Questions:

  Contact Al Collins

All Registration Forms and Entry Fees must be mailed by the 31st of March, 2009 in order for your Team to be entered into the Tournament.  The Entry Fee is $ 275.00 if it is sent before the 1st of March, and $ 300.00 if it is sent after that date.  Due to trouble with Tournament guidelines in the past there will be no exceptions to the deadlines mentioned above.

If you need a receipt, other than your cancelled check, make copy of the filled out form and use it as your receipt!