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Team Name: _____________________________________________________

Captain Name: _________________________________________________________

Email: ____________________________________ - Phone: _____________________ - Address: ____________________________________________ City: ___________________ - State: ______________ - Zip: ___________________ 

Player 2 Name: _________________________________________________________

Email: ____________________________________ - Phone: _____________________ - Address: ____________________________________________ City: ___________________ - State: ______________ - Zip: ___________________ 

Player 3 Name: _________________________________________________________

Email: ____________________________________ - Phone: _____________________ - Address: ____________________________________________ City: ___________________ - State: ______________ - Zip: ___________________ 

Player 4 Name: _________________________________________________________

Email: ____________________________________ - Phone: _____________________ - Address: ____________________________________________ City: ___________________ - State: ______________ - Zip: ___________________ Payment Options: Mail this registration form along with your check or credit card information to the following address: Checks should be in the amount of $100 and made payable to MECA, Inc. MECA, Inc. 1611 Peach Street, Suite 135, Erie, PA 16501 Credit Card Card Type: _____ Visa _____ MasterCard _____ Amex _____ Discover Name on Card : __________________________________________________________ Card Number:__________________________________________________ - Expiration Date: _____________________ CVV: ____________ (3 digit # on back of card, if Amex: 4 digit # on front of card) Signature: ________________________________________________________ For more information, call Laura at 814-454-9113 ext 226

Get your score cards at 815 State Street between 7AM to 10PM on event day! Shotgun Start: 10AM (Must be 21 years of age or older to participate)


13th Annual Barstool Open Sign-Up Form  

Sign up for the 13th Annual Barstool Open happening on Saturday 02/26/11.

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