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Bloomington South Basketball Shootout February 22nd and 23rd

Registration Form Team Name:

Grade Level_____________

Boys/Girls (circle one) Coach’s/Asst. Coach’s Names and Phone Numbers, E-mail Coach Head Coach

Name

Day

Evening

Cell.

E-mail

Asst. Coach

Asst. Coach

Head Coach’s/Contact Person’s Mailing Address (Street,City,State,Zip Code) Name: Street: City: State: Zip Code: Contact: Send your check payable to Bloomington High School South, your completed roster/release form, and the completed registration form to the address listed below by February 21st 2014: Coach Moriarity Bloomington High School South 1965 South Walnut Street Bloomington, IN 47401

Any questions or need directions Call Coach Moriarity at: Days: 812-330-7714 (work) e-mail: mmoriari@mccsc.edu

shootout-reg-form-2014-pdf  
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