RT’S AUTO And Jean-Guy Gagnon
Registration Form for RT’S AUTO

November 14th – 20th 2011

Fitchburg, MA

Team Name:__________________________________________________________

Team Representative – Name: ____________________________________________

Address:______________________________________________________________

City/Town/State:__________________________________Zip: __________________

Telephone:Home:( )_____________Work:( )_____________(Date:)_______

Team Color:___________________________Alternate Color:___________________

E-mail Address ________________________________________________________

Division Requested (circle one): 35+ B C D E and 60 +
32+ A Division.

Tournament Fee: ^$ 825.00(US Funds

Less Deposit: ^$ -________(Enclosed - ^$400 mandatory to get in)

Balance due: ^$_________ (by 1^st game)

If you can not play on a particular day circle one. (Tue Wed Thur ) . We will do our best to accommodate your request. (ONE DAY ONLY PLEASE THANK YOU.)

Return registration with deposit (Payable to: RTS AUTO HOCKEY CLUB ) to:

Marc Berube 88 Connors street FITCHBURG MA 01420

Registration is first come, first served. We will contact you if we receive your registration after our 36 team limit for the tournament has been reached.

THIS YEAR WE ARE GOING TO BE VERY STRICT ON AGES OF PLAYERS ID REQUIRED.