King of the Break Registration New Online Payment Amount for Registration: $400 (Early Team Registration December 20th - February 15th) br> Grade/Divisions (Grade that you are in now) (required): 4th5th6th7th8th9thJVVarsity18U Flag Girls Head Coach Name (required) Cell Phone Number (required) Coach Email (required) Team Mom (required) Team Mom Cell (required) Team Mom Email (required) Team Name Jersey Color Current Grade Level (required) Today's Date Parents Insurance Policy Number Assistant Coach 1 Assistant Coach 2 Assistant Coach 3 Assistant Coach 4 I understand that the registration fee is NON-REFUNDABLE once accepted into the tournament. I understand that my team is guaranteed 4 games, 3 in pool play and then 1 in single elimination bracket play. I understand that we must include a Team Roster and that roster can not be added to during tournament. The above terms and conditions have been acknowledged and agreed upon by: Please Type Your Full Name: (required) Your Signature (Initials) (required)