Lloy Ball's Official Site

2^ND MEN'S HIGH SCHOOL
CAMP REGISTRATION

TRINE UNIVERSITY - ANGOLA, IN
JULY 25th (noon) - 28th (5:00 p.m.), 2010
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, you will have a chance to print this form and you should mail it with your payment.

Applicant Information

Name:
Position:
Street Address:
City:
State:
Zip Code:
Date of Birth:
Height:
Weight:
Phone Number:
Alternate Number:
Other Contact:

Insurance Info:

Shirt Size (S,M,L,XL):
Short Size (S,M,L,XL):
Type Phrase:

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 and mailed to:

Ball Enterprises
8414 Sweet Blossom Court
Fort Wayne, IN 46835

($100.00 non-refundable deposit with balance of $250.00 due on or before July 1, 2010)
Sponsored by TeamPineapple and Ball Enterprises, Inc. (E-mail: teampineapple@verizon.net)