Harvest Cup Team Waitlist Form

Harvest Cup Team Waitlist
Team Name:*
Manager's Full Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone:*

Area CodePhone Number
Work Phone:

Area CodePhone Number
Home Phone:

Area CodePhone Number
E-mail*
Age Division*

35 and Over40 and Over48 and Over55 and Over60 and Over65 and Over60 7V765 7V7
Check here if your team needs player(s)

YES
Special Notes to Alex:
Please trace the image in the captcha*
Should be Empty: