Entry Form
Name First
Last Name
Male , Female
Choose
Male
Female
Address
State
City
ZIP
Age
E-mail
Phone
League you Play in This year
Position you can Play
Do you wish to be a manager
YES
NO
Maybe
Can you Play Friday night
YES
NO
Saturday AM
Yes
NO
After 12:00
Gift of life T-shirts
No
Yes
Size
Small
NO Shirt
Medum
Large
XLarge
XXLarge
XXXLarge
Family Team submit Manager's name above and team name here
Head of the Family Tree
(Family Teams)
You must send your check for $5.00 or $15.00 to the address below
Send check only to: Plymouth Gift Of Life P.O. Box 211 Plymouth, WI 53073
Todd Klemme
892-8242
Carleen Pickruhn 893-9783 Janice Struve 893-518
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