Name:___________________________________________________________________________________________
Address:_________________________________________________________________________________________
City:________________________________________________________________Zip Code:__________________
Telephone: (_____) ________________________
Cost: $17 Adult; $12 Child (12 and under)
Make checks payable to Rising Stars Program
| Player Name / Address | Telephone | Age | Cost |
Total Amount Paid $
|
|||
Mail Form to:
Rising Stars Program
c/o Glenn Nakatani
P.O. Box 4235
Covina, CA 91723