NJWA's Official Online Tournament Application

This is a secure form provided by the NJWA for your convenience to apply online.
Please be sure that you fill out the form completely so we can process your information promptly.
If you have any questions e-mail Mike Palinczar at: Wiffleusa@aol.com

Complete the on-line form and press the Submit button.
Your form will be emailed to the NJWA in a matter of minutes and processed promptly.

TEAM NAME:

From:(city/town)

Team Captain:

** Team Contact E-MAIL ADDRESS:

**Your e-mail address is very important, please do not skip it.
If anything is wrong with the submission, we will be unable to advise you.

TEAM CAPTAIN:
Street Address:
City:
State:
Zip Code:
Home-Phone Number:
Work or Cell Number-Number:

Player 2:
Player 2: Home-Phone Number:
Player 3:
Player 3: Home-Phone Number:
Player 4:
Player 4: Home-Phone Number:
Player 5:
Player 5: Home-Phone Number:

Type of Credit Card: (Visa and Master Card ONLY)

Credit Card #:

Exp. Date: (example 01/19/04) (mm.dd.yy)

Full Name on Card:

Registration Fee: $ (Summer Showdown Pro- $100 / Semi Pro- $75, Wiffle®Fest- $100)

Is your team in on the mailing list? Y/N