BLAST Men's Competitive Team Registration Form

Return to Registration Selection Page.. Click Here
 First Name (Team Contact)  
Last Name (Team Contact)  
Address  
City  
State    Zip  
Phone #1  
Phone #2  
E-mail Address  

I am registering a:

Team Maverick (Individual Registration)
Team Name  

Age   

Adult    Youth Age
  Male    Female
Please choose the program you are registering for:
Payment Information
($100 Non-Refundable Deposit is due before registration is finalized)
Payment is accepted online.  Acceptance into a BLAST league or event is not guaranteed until payment is received. Submission of this registration form will generate an invoice mailed to the registered address.
  Payment Options    

 

 Bill Me Visa Master Card
  Please charge my credit card for: Team Deposit Team Full Fee
 
Cardholders Name
Card Number - - -
V-Code   (What is a V-code?)
Expires
Roster and Waiver
Teams are required to submit a Roster of players and abide by the Norms and policies of the BLAST (NORMS AND POLICIES... Click Here). Each participant (or adult parent or guardian) must acknowledge by signature a waiver of liability prior to participation.

I Accept the above terms

I Decline the above terms
 
Info to our Staff
Please include any information we need to know below (Scheduling Requests)!

Copyright © 2003 Trident Sports Inc. All rights reserved.
Revised: 07/03/07.