10U, 12U B State Champ Entry

July 6-8, 2012

Complete all information and click on "Submit". Your information will be emailed to Dave Persing - Tournament Director.

Make check payble to "ASA of PA" for $450 and mail to David Persing, 311 Race Street, Sunbury, PA 17801 within 7 days of submittng entry.

 

10U & 12U Class B State Championship
*
Team Name*
Age Group *
Manager's Name *
First Name
Middle
Last Name
Manager's Address *
Address Line 1
Address Line 2
City
State
Postal Code
Home Phone:*
Cell Phone:*
Email Address*
Team's Home District or County*
NOTE: 2012 ASA Background Checks required for all adult members of team. At least 1 coach must have 2012 ACE Certification. Proof of clearance and/or completion must be presented at check-in.