TORHS America 2008 Team Entry Form
Tournament Site:		Tournament Date:
Team Name:		Age Division:
Age Division Choices: Tyke (6U), Atom (8U), Mite (10U), Squirt (12U), Peewee (14U), Bantam (16U), Midget (18U), Junior (21U), Adult, Senior (30+), PRO, Women, High School
Address:		City/State/Zip:
Coach/Contact:		E-Mail:
Phone Number:		Work/Cell Number:
Rink/League you represent:
Fax Entry form to: 314-487-9554
Mail Entry Form and Payment to:
TORHS America
11133 Lindbergh Ct.
St. Louis, MO 63123
Regional Entry Fee: $535.00		Winter Cup Finals: $695.00
NICC Championships: $550.00		National Championships: $835.00
Form of Payment:
Mail Check:		Date Mailed:
Credit Card:		Info below:
NO PERSONAL CHECKS ACCEPTED AT THE EVENT.
Please send payment as a money order, cashier's check, credit card or club checks are accepted.
REFUND POLICY
Refunds will only be issued if the tournament you are registered for is cancelled.
No refunds will be issued to teams that register for an event and do not show.
Credit Card Payments Accepted
If entered by fax, please call 314-779-7755 to confirm that your fax has been received.
Fill in this section below for credit card payment
Amount of Payment:
Visa	Mastercard		American Express
Card #:		Expiration Date:
Billing Address:		City/State/Zip:
Print Name:		Signature: