Corporate Challenge Dodgeball Registration

Team Information

Corporate Name*

Dodgeball Team Name

Team Captain Name*

First Last

Team Captain Phone*

Alternate Phone Number*

Team Captain Email*

Team Captain Address*

Street Address Address Line 2 City State ZIP Code

Entry Information

Product Name*

Please indicate which division your team will be playing,

Team Roster*

List all members that will be playing, including alternates. The maximum medals awarded per team is 8. Click on the + to add lines.

Last Name	First Name	Age	Phone

Registration Total

$0.00

By hitting SUBMIT, you will be sent to a Paypal page to complete the registration process. You may pay with a credit card OR a Paypal account. You do not need to set up a Paypal account to pay with a credit card. You are NOT registered if payment has not been received. There are no refunds for non attendance.