Please fill out one form for each team entered.

March 1-3, 2012

Cost: $250 per team
Make checks payable to: NDIICHA                                                            REGISTRATION DEADLINE: February 1, 2012

Team Name: ________________________________________

Team Uniform Colors:_________________________________

City and State Location:_______________________________

Bracket: (Check one)
High School Boys____  High School Girls ____ 

Junior High Boys ____  Junior High Girls ____

Head Coach: ________________________________________
E-mail address: ______________________________________
Phone Number: Primary _______________  Cell _________________

Assistant Coaches: ___________________________________

Managers: __________________________________________

Athletic Director:
Name:_____________________________________________________
E-mail Address:______________________________________________
Postal Address: Street:________________________________________
                      City:________________ State:_______  Zip:_________
Phone Number: Primary__________________  Cell_________________

A.D. (preferred) or coach must answer the following two questions to be accepted into the tournament.
1) How many times, on average, does your team practice in a week?  _____
2) How many total games will your team play prior to NDII 2012 tournament? ____

Roster in numerical order:
Jersey Number, First Name, Last Name, Height, Grade, Birth Date
Example:
#15      SusieTennison    5'8"    12    12.10.93

Team Record: Include all games through January 31, 2012.                                             • Name of opponent, win/loss, scores of regular season and tournament games. Tournament seeding will be based on information submitted.  Please make note if you are playing a varsity, junior varsity, 'A' or 'B' team. 
Example:
Stafford Trojans 'A'     45-49      Win                                                                              

Team Picture:
    • One for each team, a digital picture, color or black and white. Send via e-mail to director. Players and coaches line up in two or three rows with numbers and faces showing clearly.

NOTE: Information collected is for the exclusive use of the Director and NDIICHA 2012 Program.  Phone numbers and addresses are necessary for the Director's communication with teams and are for her records alone.

~~~

Submit completed player info and team record (Microsoft Excel or Microsoft Word Document format) via e-mail to:  nd2chadirector@yahoo.com

Send registration fee to:               

Kelly Love                                                                                                         14010 W. Lake Cable Road
Partridge, Kansas  67566