Entry Form

Grade Bracket:

Team Name:

Skill Level:

Coach:

Contact:

Email:

Phone (Primary):

Phone (Secondary):

Street:

City:

State:

Zip:

Send $125 entry BY Saturday, November 24^th to:

Michael Ricke

1144 West Avenue N

Madison, SD 57042

(605) 480-0837

entry@madisonboosterclub.com

You are not entered until we receive the entry fee! Include your team name on check. Checks are NON-REFUNDABLE unless brackets have already been filled!

Team Roster

*At least five players required.

Player:

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Player:

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Player:

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Player:

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Player:

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Player:

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Player:

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Player:

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Player:

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