PRINT THIS FORM OUT

Billerica Mite Classic Tournament

APPLICATION FORM 2022

TEAM NAME:__________________________________________________________

TEAM LEVEL: _________________

TEAM MANAGER:______________________________________________________

ADDRESS_____________________________CITY/STATE/ZIP__________________

EMAIL ADDRESS_______________________________________________________

HOME PHONE#_________________________CELL PHONE#___________________

HEAD COACH:__________________________________________________________

ADDRESS_____________________________CITY/STATE/ZIP__________________

EMAIL ADDRESS_______________________________________________________

HOME PHONE#_________________________CELL PHONE#___________________

PLEASE PRINT THIS FORM AND MAKE PAYMENTS IN U.S. FUNDS PAYABLE TO:

Billerica Hockey Association

C/O Tony Medeiros

PO Box 347

Billerica, MASS. 01821

***COST: $800.00 PER TEAM***

**PLEASE SEND A $800 NON-REFUNDABLE DEPOSIT PER TEAM BY March 1st, 2022**

***OUR TOURNAMENT COMMITTEE WILL NOTIFY THOSE TEAMS ACCEPTED TO PLAY IN OUR TOURNAMENT BY March 5th 2022***

***ANY TEAM NOT ACCEPTED TO PLAY IN OUR TOURNAMENT WILL RECEIVE THEIR DEPOSIT BACK***

** This tourney will be selected by the order in which we receive the deposit & application and Please provide check number_____________