15 & Under Bash Entry fee: $155 if received by June 13th, $165 if received from June 16th through June 20th
Team Name:_________________________________________________________ Contact Person: ______________________________________________________ Address: ____________________________________________________________
City: ______________________St: _______ Zip: ______________ Phone (Home): ______________________ Phone (Work): ______________________ Fax: ______________________________
June 20, 21, 22 2003
Make checks payable to: Russell Recreation
P.O. Box 382
Russell, KS 67665