Reserve your spot on the roster today! Please enable JavaScript in your browser to complete this form.Last NameFirst NamePhoneEmail *Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePut me on the roster! I'm playing!Sign me up - $20.00Would you like to add $1.00 to cover credit card processing fees? *Yes! - $1.00No thanks - $0.00I'd like to make a donation to help support the Ted Jasieniecki ScholarshipDonate - $10.00Donate - $25.00Donate - $50.00Donate - $100.00Total *$0.00Total amount for player entry and/or scholarship donation. Payments are accepted via credit card. Payment Method *Credit CardCredit Card *CardName on CardSubmit
