loyal corn fest HUMAN FOOSBALL

team registration
team name:
Team Contact name:

Team contact Phone number:

Parent signed waiver (if

Team member name Age* Waiver completed under 18)

Yes/No Yes/No

Yes/No Yes/No

Yes/No Yes/No

Yes/No Yes/No

Yes/No Yes/No

Yes/No Yes/No

*Recommended for players taller than 4 feet. Six people per team.

play time is approximately 15 minutes

Mail completed team form, waivers, and $20 payment to:

Loyal Corn Fest HUMAN FOOSBALL
c/o jodie Gardner
N7675 Division Ave
Spencer, WI 54479

Questions? Call: 715-897-7142

REGISTRATION/PAYMENT MUST BE RECEIVED BY 8/25/17

Checks should be made payable to: Loyal Corn Fest