Victoria Playmakers Tournament

Please mail this completed form with your entry fee of $65.00 CDN/US to Ken Bray, Playmakers Tournament Registrar, 2425 Dunlevy St. Victoria, BC V8R 5Z1 by December 31, 2011. Please make cheques payable to Victoria Playmakers Tournament. Thanks for your help. If you have any questions please do not hesitate to contact us.

Name	__________________________
Email address	__________________________
Street address	__________________________
City	__________________________
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Phone number (area code)	__________________________
Date of birth	__________________________
Positions desired	__________________________
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