Five Star Team Submisson

Season: Winter 2010-2011

Team Name: Division:
Captain Name: Captain Email:
Alt Captain Name: Alt Captain Email:
Alt Captain Name: Alt Captain Email:
Home Colour: Away Colour:
Payment Enclosed:

This Season's Team Fee is: $6,400.00. The full payment discount is: $300.00 .

**Please note: The final division you participate in will be based on the roster you submit and may not reflect your initial selection!

A minimum of a $500 non refundable deposit is required to be included in the new season's schedule.

**Please enter a numerical value for Payment Enclosed, i.e., 6000 with no $ symbol or decimals**

Please contact Bob Nelson with any questions.