Lloy Ball's Official Site

FANTASY VOLLEYBALL
CAMP REGISTRATION

August 2, 3, 4, 5 (2009)
Trine University - Angola, Indiana
(Cost - $3,000.00 - includes meals, lodging,
instruction, matches, uniforms, balls)

Website: www.teampineapple.com
E-mail: teampineapple@verizon.net

Applicant Instructions

Please fill out all of the form entries below. Please note that the applicant should fill out the form and the "printed name" below must be the same as the applicant's name. Upon successful submission, an email will be sent to both Team Pineapple and your email address. You will also have a chance to print this form after submission.

Applicant Information
(Note: Must be 30 years of age to apply and attend this camp.)

Name:
Position:
Street Address:
City:
State:
Zip Code:
Date of Birth:
Height:
Weight:
Phone Number:
Alternate Number:
E-mail Address:
Other Contact:
Insurance Info:

Agreement

Team Pineapple, Ball Enterprises, Lloy Ball, or Arnie Ball, shall not be held responsible for any injuries or damages incurred by Applicant.

Printed Name:

Checks or money orders should be made payable to:

Ball Enterprises
8414 Sweet Blossom Court
Fort Wayne, IN 46835

($500.00 non-refundable deposit with balance of $2,500.00 due on or before July 24, 2009)