2012----2013 LEAGUE REGISTRATION
Name:
________________________________________________________________________
Address:
________________________________________________________________________
Address:
________________________________________________________________________
State: Zip Code:
________________________________________________________________________
Phone:
________________________________________________________________________
Email:
_____________________________________________________________________________________________
Forming a team or do you wish to be placed on a team? (team) (individual)
Circle desired position: Skip Third Second Lead
If forming a team who are they?
1 3
2 4
COST: Junior $ (age 21 and under)
Adult $ (age 22 and above)
Social $ (no curling)
Register and pay before () and save $ 1/2 season (8 games) is half the cost
2012---2013 SEASON:
NOV DEC JAN FEB MAR Make checks payable to the "Aksarben Curling Club"
Lyle Jaixen, club treasurer
10418 Mary Circle
Omaha, NE 68122 |