Bloomington South Basketball Shootout February 22nd and 23rd
Registration Form Team Name:
Grade Level_____________
Boys/Girls (circle one) Coach’s/Asst. Coach’s Names and Phone Numbers, E-mail Coach Head Coach
Name
Day
Evening
Cell.
Asst. Coach
Asst. Coach
Head Coach’s/Contact Person’s Mailing Address (Street,City,State,Zip Code) Name: Street: City: State: Zip Code: Contact: Send your check payable to Bloomington High School South, your completed roster/release form, and the completed registration form to the address listed below by February 21st 2014: Coach Moriarity Bloomington High School South 1965 South Walnut Street Bloomington, IN 47401
Any questions or need directions Call Coach Moriarity at: Days: 812-330-7714 (work) e-mail: mmoriari@mccsc.edu