^{Blitz Sports
1105 Calico Ln. Apt. 1621
Arlington, Tx. 76011}

Team Name:     _______________________________
Team Captain:   _______________________________
Phone Number: ________________________________
Email Address:  ________________________________
Name of alternate captain: _______________________
Phone Number: _______________________________
Email address: ________________________________
Amount enclosed: ______________________________

Tournament Registration will run until Saturday, July 9th, 2005. Registration is complete with $350.00 and this registration form in my hands.

Please make checks or money orders payable to:
Blitz Sports
Cash is also accepted.
Please mail to the address at the top of this registration form.

If you have any questions:
http://blitzflagfootball.20m.com
blitzflagfootball@hotmail.com
Or call Jon Cordio at (817) 676-2528