1st

Annual Haskell vs. KU Benefit Iron-Man +1 Basketball Challenge

December 6-7, 2013
Tecumseh Gymnasium, Haskell Indian Nations University,
Lawrence, KS

REGISTRATION FORM
DEADLINE: NOVEMBER 30, 2013

College (circle one): HINU KU
Team Name:_________________________________________________________________
Team Captain (Primary Contact):_________________________________________
Address:________________________________ Mobile:____________________________
Email:___________________________________

TOURNAMENT FEE IS $120/TEAM ($20/PERSON)

**** ALL TEAMS MUST HAVE 6 PEOPLE FOR SUBSTITITON IN CASE OF INJURY****
****Open to the first 8 Haskell and first 8 KU teams****
***No exceptions, refunds will be available if at capacity***

Name
Mobile
Captain:

2.

3.

4.

5.

6.


Team Captain Authorized Signature:_____________________________________________________

**Registration Form Must be Complete and Entry Fee Must be Enclosed in Order
for Registration to be Valid**

(If a KU team)
****Make Check/Cash/Money Order Payable to: FIRST NATIONS STUDENT
ASSOCIATION****
Mail/Deliver Payment To: 1301 Jayhawk Blvd, Kansas Union, Room 400,
Lawrence, KS 66045

(If a Haskell team)
****Make Check/Cash/Money Order Payable to: FIRST NATIONS STUDENT
ASSOCIATION****
Deliver Payment to: Rex Cully, Campus Activities Association, Tecumseh Hall