ADULT REGISTRATION FORM
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SPORT         TEAM NAME  

LEAGUE:          YEAR:     SEASON:

Person to CONTACT with any and all information pertaining to this team:

NAME:         BUSINESS PHONE: ()

ADDRESS:       HOME PHONE:       ()

CITY/STATE:        ZIP CODE:


NAME:         

BUSINESS PHONE: ()

ADDRESS:       HOME PHONE: ()

CITY/STATE:        ZIP CODE:


REGISTRATION FEE FOR:             $

REGISTRATION FEE PAID BY:             $

DATE PAID:     CASH/CHECK#:     AMOUNT PAID: $

NOTE
It is the team's responsibility to notify the Parks and Recreation Office in case of any changes in the CONTACT PERSON. Cancellation of any games will be played at the discretion of the Sports-Coordinator.

SCHEDULE AND RULES RECEIVED BY:______________________________________________

(Signature)_________________________________        (Date)______________________

Mail forms to:
West Plains Parks and Recreation
1135 West Broadway
West Plains, Missouri  65775