2012 Registration form

Individual Fee $40 per Child

Only entries postmarked by Jan. 4 accepted.

Draft to be Jan. 13, Practices start Jan. 28, Games start Feb. 25

No teams play every night.

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Player name:__________________________________________­­­­__________

Address:________________________________________________________

Phone:_____________________­­­­____________

Grade:_______________

Shirt Size: Youth S M L Adult S M L XL (One per child)

If you played Jr. Pro last year, name of your team __________________

If you do not wish to play on the same team, Check Here ( )

Parent Name (Please Print) _______________________________

Parent signature ________________________________________

Coaches Only ** Coaches needed, must be 18 years of age

Name:______________________________________

New ( ) Returning ( )

Name of team coached last year:_______________________________

Defeated Elementary sponsors this program. All check should be made payable to DEFEATED ELEMENTARY SCHOOL. Mail to: DES JR. PRO, 451 Defeated Creek Hwy, Carthage TN, 37030. For more info, contact DES at 615-774-3150 or Brandon Rigsby at 615-774-3421.