Deadline: August 10, 2010
Annual MCSSA dues are $5.00 per year. To participate in
our activities, membership is required.
Fill out and mail in this form.
I want to play in the Super Senior Coed Monday mornings draft
League ($25) $_______
I want to play in the 60+ Tuesday/Thursday mornings draft league ($55)
$______
I want to play in the 50+ draft league on Friday nights
($60)
$________
include $5.00 for Annual MCSSA Membership
$_________
Optional: Donation to MCSSA to further MCSSA goals
$_________
TOTAL AMOUNT DUE
$_________
NAME:_______________________________________________________phone:_______________
Address:__________________________________________________________________________
City______________________________ State_______ Zip____________
Birth date____________
E-mail______________________________________________
Emergency
contact____________________________________________phone____________
Would you like to manage a team in one of the leagues? YES
NO
Mail copy of this form with check for TOTAL AMOUNT DUE
payable to MCSSA to:
MCSSA
14320 Fairdale Road
Silver Spring MD 20905
Deadline: August 10, 2010
