PRUMC Sports and Recreation Softball Team Registration
TEAM NAME: __________________________________________________________
CHURCH AFFILIATION: _________________________________________________
Check the appropriate box. One Registration Per Team:
______ This is a registration for one Men’s team
______ This is a registration for one Co-ed team
** Each
Team’s Dues ARE $650 **
Please fill in all areas below. It will save time if we have all the
information listed below.
Please provide two contacts per team and one form per team. Thank You.
MANAGER:
______________________________________________________________________________________
ADDRESS: ________________________________________________________________________________________
NUMBER & STREET CITY ZIP
PHONE: ___________________________(HOME) _________________________(WORK)
___________________________(FAX) _________________________(BEEPER/CELL)
E-MAIL ADDRESS: ______________________________________________________
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ASSISTANT MANAGER: ___________________________________________________________________________
ADDRESS: ________________________________________________________________________________________
NUMBER & STREET CITY ZIP
PHONE: ___________________________ (HOME) __________________________(WORK)
___________________________(FAX) ___________________________(BEEPER/CELL)
E-MAIL ADDRESS: ________________________________________________________________________________
Application forms for Teams from PRUMC can be faxed to PRUMC Sports and Recreation (Fax - 404 266-0063) , dropped off , or mailed to PRUMC Sports and Recreation, 3180 Peachtree Rd, Atlanta, GA 30305 with a check payable to PRUMC.
Circle payment type: Cash / Check (pay to PRUMC) / Credit Card: Visa or MC Exp. Date: ____ / ____
Card/ Check #: _____________________________________________ Amount: _________________
Cardholder Address: _______________________________________________________________
City___________________ State_______ Zip________________
Signature: _________________________________________________ Date: ____________
__________________________________FOR OFFICIAL USE ONLY________________________________
Amount Paid __________ Balance Due: ________ Check # __________ Date Rec’d. ___________ Rec’d. By ____________
Balance Paid __________ Check # __________ Date Rec’d. ___________ Rec’d. By ____________