Player One

Address Apt.

City Prov. Postal Code -

Email Telephone Number - -

Player Two

Address Apt.

City Prov. Postal Code -

Email Telephone Number - -

Player Three

Address Apt.

City Prov. Postal Code -

Email Telephone Number - -

Player Four

Address Apt.

City Prov. Postal Code -

Email Telephone Number - -

Amount Enclosed $ .00 (cheque only, please do not post date)

ENCLOSE CHEQUE AND MAIL TO:

Jack Canavan
8 Keller Lane
Uxbridge ON L9P 1Z4