PAY AND REGISTER VIA EVENTBRITE REGISTRATION
Registration Form |
||
TEAM Name: |
||
DIVISION (check): □Pro* □Semi-Pro* □Rebel* □Student ($30 per team**) |
||
Team Leader |
||
| Name: | ||
| Address: | ||
| City: | State: | ZIP Code: |
| Email: | Phone: | T-Shirt Size: S M L XL 2X |
Player 2 |
||
| Name: | ||
| Address: | ||
| City: | State: | ZIP Code: |
| Email: | Phone: | T-Shirt Size: S M L XL 2X |
Player 3 |
||
| Name: | ||
| Address: | Address: | |
| City: | State: | Zip Code: |
| Email: | Phone: | T-Shirt Size: S M L XL 2X |
Payment Options |
||
| Mail your registration form with a check or money order to: The Literacy Center Attn: SCRABBLE® 3411a N First Ave. Evansville IN 47710 or pay by credit card by completing below. | ||
| Name on Card: | Credit Card Type: (circle) Visa- Master Card – Discover | |
| Credit Card #: | Expiration Date: | |
| Amount to charge: $ | ||
| Signature of card holder: | Date: | |