BARNESTON 125th
ANNIVERSARY CELEBRATION
3 ON 3 BASKETBALL TOURNAMENT
Saturday May 30, 2009
10:00 AM at the BARNESTON
COMMUNITY CENTER
DIVISIONS:
(A) 2009 SENIORS AND UNDER
(B) ANY AGE ABOVE 2009 SENIOR
COST: $10.00 PER
PLAYER (UP TO FOUR PLAYERS)
PROCEEDS TO BENEFIT
THE BARNESTON COMMUNITY CENTER
PLEASE COMPLETE
ATTACHED ENTRY FORM/WAIVER AND SEND TO:
BILL PETERSEN
P.O. BOX 266
WYMORE, NE 68466
Deadline for entries
is Saturday - May 23, 2009
Brackets to be mailed out if time permits
Questions please contact
-
Bill Petersen 674-3350 or
228-6761
Skip Barr 696-3350 or 228-6075
___________________________________________________________________
Team Name _____________________________
# of players__________
Mailing Address___________________________
Division A or B (circle one)
_______________________________________
Amount enclosed ___________________
(make checks payable to
Barneston Community Center)
Waiver: The UNDERSIGNED
is aware that there are risks associated with this activity and
hereby release and waive the Village of Barneston, Barneston
Community Center, organizers, and volunteers from any and all
personal or property liability. The UNDERSIGNED also agrees to
adhere to all the rules that are associated with this event.
(Must be signed by a parent
if player is under 18)
Player #1 __________________Parent
Signature_____________________
Player #2__________________
Parent Signature_____________________
Player #3__________________
Parent Signature_____________________
Player #4__________________
Parent Signature_____________________