ENTRY FORM FOR BP ALL*STARS 
                       16U/18U   FRIENDLY SUNDAYS


TEAM NAME:___________________________

TEAM CONTACT:_________________________

CONTACT PHONE:___________________________

CONTACT EMAIL:___________________________

 DATE(S) 

MAKE CHECK PAYABLE TO: TED KOZLOWSKI

$150 PER DATE/ 3 GAMES

MAIL TO:
TED KOZLOWSKI
38 CHICHESTER RD
HUNTINGTON STATION
NEW YORK  11746