18U A State Champ Entry App

June 22 -24, 2012 - Sellersville, PA

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

Make check payable to "ASA of PA" for $450 and mail to:  Jeff Sell, 1719 Lake Shore Drive, Pennsburg, PA 18073 within 7 days of submitting entry.

 

18U Class A State Championship
*
Team Name*
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.