Team Name:_____________________________________________________
Captain (First) ___________________________ (M)______(Last)_______________________
Address ________________________________________________________
City ____________________________________ State_________________ Zip____________
Phone (___)__________________Email ___________________________
I understand that the Registration Fee is NON-REFUNDABLE
I have enclosed a check or money order for $100.00 OR I wish to have the $100.00 charged to my
MasterCard - Visa - Discover - Amex #___________________________________ Exp_______
Signature_____________________________________________________________________
Enclose payment with form and mail to
Pinnacle Woods Paintball - 8752 East Ave. - Mentor, Oh 44060-4304
Please call our Mentor Store at 440-974-0077 or our Strongsville Store at 440-846-0441