Team Name:_____________________________

Division Entering:_________________________
Manager:________________________________
Phone Home :____________________________
Phone Work:_____________________________
Address:_________________________________
City:________________________ Zip_________
mail:___________________________________

Umpires:
Name __________________ Phone ____________
Name __________________ Phone ____________

Team Roster:
1._________________________________________
2. ________________________________________
3._________________________________________
4. ________________________________________
5._________________________________________
6._________________________________________
7._________________________________________
8. ________________________________________
9._________________________________________
10.________________________________________

Tournament Fee:

Umpires* ______________2@ $50.00=$100.00

Div I _____________________________ $300.00
Div II _____________________________$250.00
Div III_____________________________$200.00

Total Dues: $_______

*May be omitted if umpires are identified and approved

Please mail check payable to:

Huntington Beach Surfers Field Hockey

2960 Tarocco Drive .
Corona , Ca 92881
Phone: 909-735-6266
Fax: 909-735-1545
Email: hbfhc@surfersfieldhockey.com
www.surfersfieldhockey.com