*FIRST NAME:


*LAST NAME:


*TEAM NAME:
[FREE AGENT] BAD TOUCH COBRA KAI CORLEARS HOOKERS DARK RAINBOWS DENIM DEMONS FILTHY GORGEOUS FRESH KILLS GOUGING ANKLEBITERS HAPPY LITTLE ELVES LBS MATHEMATICS MEXICAN STANDOFF MIGHTY SQUIRRELS REHABS SKYFIGHTERS TUQUES UNICORNS WHAT THE PUCK

*PLAYED IN BTSH LAST SEASON:
Yes No

*GENDER:
Male Female

*MAILING ADDRESS:


*PHONE NUMBER (to be used to contact you about game cancellations, etc.):


*EMAIL:


*GOALIE:
Yes No

*I'M A REF:
Yes No

*I'M NOT A REF, BUT I'M INTERESTED IN REFFING:
Yes No

COMMENTS:


*BY SELECTING THIS BOX AND SUBMITTING THIS FORM I AGREE TO AND ACCEPT THE AGREEMENT AND TERMS SET FORTH BELOW: