NBBA TEAM CONTACT/BILLING FORM
*TEAM ROSTER MEMBERSHIP*
INITIAL ROSTER DUE: JUNE 1st
FINAL ROSTER DUE: JULY 1st
TEAM NAME:___________________________ YEAR:__________
TEAM CONTACTS (Please list 2):
NAME:_______________________________________
ADDRESS:____________________________________
CITY,STATE,ZIP:_____________________________
PHONE NUMBER:
(Home)_________________________ (Work)_________________________
NAME:_______________________________________
ADDRESS:____________________________________
CITY,STATE,ZIP:_____________________________
PHONE NUMBER:
(Home)_________________________ (Work)_________________________
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INDIVIDUAL MEMBERSHIPS: (NOTE: All memberships are $20 after 6/1)
______ Regular Members @ $10.00/member (until 6/1) $______
______ Regular Members @ $20.00/member (after 6/1) $______
______ Family Members @ $10.00/member $______
______ Child Members @ $10/member (Age 12 & under) $______
WORLD SERIES REGISTRATION: $310 per team $________
TOTAL DUE: $_________
**MAKE CHECKS PAYABLE TO NBBA.
SEND THIS FORM, A COPY OF YOUR TEAM ROSTER/MEMBERSHIP FORM, AND A CHECK (NO LATER THAN JUNE 1st AND JULY 1st) TO:
JEANA WEIGAND, NBBA SECRETARY
If you have questions concerning this form, please call Jeana at (614) 442-1444.