King of the Break Registration Online Payment Amount for Registration: $600 Divisions (required): 5th6th7th8th9th18U 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 League Name League President League Insurance Policy Number Assistant Coach 1 Assistant Coach 2 Assistant Coach 3 Assistant Coach 4 I understand that the deposit of $600 registration fee is non-refundable once accepted into the tournament. Furthermore, I understand that this deposit is only to secure my spot and does not cover the team fees to participate. I understand that we must include an Official Team Roster provided by your league, which lists all Player’s Names, Birth Dates, Weights and Jersey Numbers. The above terms and conditions have been acknowledged and agreed upon by: Please Type Your Full Name: (required) Your Signature (Initials) (required)
