Elks Pepsi Classic Online Entry

Girls - August 21st, 22nd, 23rd 

Boys - August 28th, 29th, 30th<form method="post" action="http://www.emailmeform.com/fid.php?formid=91839" enctype="multipart/form-data" accept-charset="UTF-8">
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<font face="Arial Narrow" size="3" color="#000000">Tournament Application - 

Please confirm your teams age group is listed correct before submitting. </font>
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 <td><font face="Arial Narrow" size="3" color="#000000">Team Name </font></td>
 <td><input type="text" name="FieldData0" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Team Color </font></td>
 <td><input type="text" name="FieldData1" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Team Age Group </font></td>
 <td><select name="FieldData2"><option value="U08">U08</option><option value="U09">U09</option><option value="U10">U10</option><option value="U11">U11</option><option value="U12">U12</option><option value="U13">U13</option><option value="U14">U14</option><option value="U15">U15</option><option value="U16">U16</option><option value="U17">U17</option><option value="U18">U18</option><option value="U19">U19</option></select> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Boys or Girls </font></td>
 <td><select name="FieldData3"><option value="Boys">Boys</option><option value="Girls">Girls</option></select> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Coach Name </font></td>
 <td><input type="text" name="FieldData4" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Coach Address </font></td>
 <td><textarea name="FieldData5" cols="60" rows="10"></textarea><br> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Coach Phone </font></td>
 <td><input type="text" name="FieldData6" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Coach Email </font></td>
 <td><input type="text" name="FieldData7" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Manager Name </font></td>
 <td><input type="text" name="FieldData8" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Manager Address </font></td>
 <td><textarea name="FieldData9" cols="60" rows="10"></textarea><br> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Manager Phone </font></td>
 <td><input type="text" name="FieldData10" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Manager Email </font></td>
 <td><input type="text" name="FieldData11" size="40"> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Team Stats </font></td>
 <td><textarea name="FieldData12" cols="60" rows="10"></textarea><br> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">Team Conflicts </font></td>
 <td><textarea name="FieldData13" cols="60" rows="10"></textarea><br> </td>
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 <td><font face="Arial Narrow" size="3" color="#000000">U12 Choose 8 v 8 or 11 v 11 </font></td>
 <td><select name="FieldData14"><option value="8 v 8">8 v 8</option><option value="11v11 ">11v11 </option></select> </td>
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<input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;">
<input type="submit" class="btn" value="Submit" name="Submit">&nbsp; &nbsp; <input type="reset" class="btn" value="  Clear  " name="Clear"></td>
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Your Application will not be final until your payment has been recieved. 

Please make check payable to: Elks Youth Atheltics                                                   

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Elks Pepsi Classic                                          
2227 State Street                                           
Granite City, IL 62040