Tournament Site:

In The Net,    Palmyra, PA                      

Date of Event:

Club/Team Name:

 Team Age:

Team Rep:

Team Coach:

Address:

Coach's Phone:

City/State/Zip:

Coach's Email:

Rep Email:

Club Registration #

Rep Phone:

PLAYER / COACH NAME

UNIFORM #

AAU #

GRAND PRIX: $500.00

Mail entries to:

Volleyball Corner

2007 Lincoln Hwy East

Lancaster, PA 17602

Checks Payable to:

Middle Atlantic Volleyball

The entry blank must be completed in full, signed by the team representative and accompanied by the entry fee in order to be valid for acceptance into the tournament. The undersigned hereby certifies that the information provided is accurate. The host tournament director, at his/her discretion may request the provision of an individual member's AAU registration card and a picture ID for the purpose of verifying a player's eligibility.

Signature of Team Representative:

Date: