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Mattawa Dodge Ball Registration 2015
Held at the Mattawa Arena
Name: ________________________________________ Age: ________
Allergies ___________________________Meds:__________________________
Phone Number: _______________________________Birth Date:_____________
In Case of Emergency/ Contact _______________________#_________________
E-mail:____________________________________________________________
Starting Wednesday June 24th
Kid’s Divisions ------------------------------ Wednesdays
___$30 Squirts ages 4-6 ------------------------------- 4-5pm
___$40 Juniors ages 7-10 ----------------------------- 5-6pm
___$40 Intermediate ages 11-14 -------------------- 6-7pm
___$40 Seniors ages 15-18------------------------------7-8pm
Please circle Shirt Size:
Method of payment:
S / M/ L/ xL
Cash
Child______ Youth________Adult_______
Cheque
Signature: ____________________________________
Date: __________________
If you are willing to help with Dodge Ball this summer please sign below!!!
Name:______________________________________________Number:_________________________________________
Please be advised ALL volunteers MUST have a police checks completed for this
position…. Thank You!