Name of team     Classification (A, B, BB, CC):  

Name of Manager:  Home telephone:

Address of Manager (street, town, province):
                

Email  :

Fax number : 

League Name :  Date : 

To which other tournaments are you registered ? ( maximum of 3 )

 

Restrictions: Do you have dates restrictions (scheduled games in your league, other tournament, etc...)  If yes, let us know:


If in one class, the number of inscriptions exceeds the number of teams accepted, the priority will go to the teams with less restrictions.

This online inscription form will be in effect when we receive your cheque by mail.
( 450$/quebec team; 500$CDN/outside of quebec)

This online inscription form AND the cheque should be return BEFORE OCTOBER 10^th, 2011

Mousquiri National Atom Tournament P.O. Box 3125 Richmond, Qc,Ca J0B 2H0

Phone number: 819- 570-3719 Fax: 819-826-1970

www.mousquiri.com tournoiatome@mousquiri.com guillaume.mousquiri@yahoo.ca