DODGE BALL TOURNAMENT

PLAYER REGISTRATION FORM - PERMISSION FORM

Students under the age of 18 must have a parent/guardian signature

CMA Church will be sponsoring it's First Annual DODGE BALL TOURNAMENT, to

raise money for a Summer 2007 Youth Trip.

SATURDAY FEBRUARY 3RD starting at 10:00am in the GYM.

Teams of 8 players will compete in a DOUBLE ELIMINATION bracket. 

        NAMES of Players; _______________, __________________, _____________

           _________________,  _________________, _________________,

        ___________________, _________________

    Contact Address;  ________________________  City __________________

        State _____________  Zip ______  E-Mail Address _____________________

    GRADE LEVEL _____________  TELEPHONE NUMBER ___________________

    COST;  $30.00 per team.  All grade levels

    Please turn this form to the Church Office/ Attention Robin Ellenberger, along with a check made out to Punxsutawney Alliance Church.  Check web site for information.

I, the undersigned, individually or as parent(s) and / or guardian of said player ask that he / she/ be admitted to participate in the sport competition.  In association of such admission, I do herby release, discharge, and hold harmless Punxsutawney Alliance Church and all officers, agents, volunteers, sponsors and employees if and from all causes, liabilities, damages, claims or demands whatsoever on account of any injury or accident involving the said individual attendance at the sport competition and / or activities held in connection with the event.

Parents Signatures ______________________, ______________________, __________________,

_____________________, ______________________, ____________________________,

_________________________, ___________________________

GRADE LEVEL TIMES:    5TH - 6TH  10:00AM   /   7TH - 9TH   10:00AM / 10TH AND UP   2:00PM

TO ENSURE THE MAXIMUM SAFETY, ALL COMPETITORS MUST WEAR PROTECTIVE GOGGLES, EITHER BRING YOUR OWN OR SOME WILL BE PROVIDED.  COMPETITORS MUST ALSO WEAR NON-MARKING GYM SHOES.

*ALL TEAMS MUST WEAR TEAM SHIRTS (OR UNIFORMS IF YOU WANT), AN AWARD WILL BE PRESENTED TO BEST SHIRTS OR UNIFORMS

        **  BE HERE 1/2 HOUR EARLY FOR YOUR TIME BRACKET!!!!!!!

Web site   pcmayouth.com     Church Phone  814-938-8505      Fax  814-938-8584

**CONCESSIONS WILL BE AVAILABLE......   Name of Youth who signed you up __________________________________