2010 Hueytown Purple & Gold Classic
A Great Spring Tradition Since 2004
Fill out this form and Print or
Click Submit to reserve your spot.
You are not REGISTERED until we receive your check

8U - $60 Rec Teams Only for 2010
All others - $200

Make Checks payable to BIRMINGHAM MUSTANGS & mail entry form to :

Gary K Wray
1040 Arcadia Circle
Hueytown, AL 35023

205-612-3082
garykwray@gmail.com

Please include the Team Name and Age Division on Check

Team Name
Age Division
Coach Name
Manager's Name
Street Address
City, State, Zip
Telephone
Fax
Email Address
NSA Sanction Number
Insurance Policy & Number

Entry is NOT CONFIRMED until check has been received.
Deadline for payment is March 22, 2010
unless arrangements have been made