YOUTH NAME:_____________________________

YOUTH AGE:_______YOUTH T-SHIRT SIZE:_______

ADULT NAME:______________________________

ADULT AGE:________

ADDRESS:_________________________________

CITY:___________________ STATE:____ ZIP:_______

PHONE:_______________________

$15 Entry fee per person ($30 per team).  Entry fee must be paid when returning this form.  Limited space is available, only the first 30 teams will be accepted.  Only the youth will receive a tournament t-shirt.

If you have any questions please contact Keith or Jon at the Avon Pier (252) 995-5480 or Info@avonpier.com