Berkshire Blaze PONY Qualifier

Team Contact Information

 

Please fill out the below information and email ii back to KAmeen2128@aol.com or mail it to

 

Mike Ameen

C/O Berkshire Blaze

49 Marion Ave

North Adams, MA, 01247

 

Team Name___________________________________________________

 

Manager/Contact Name_________________________________________________

 

Mailing Address___________________________________________________

 

City, State, Zip_________________________________________________________

 

Phone #’s Home___________________________________

 

                 Cell_____________________________________________________

 

                 Work___________________________________________________

 

Hotel Name________________________________________________________

 

Hotel Phone Number_________________________________________________

 

Hotel Room Number of Team Contact________________________________

 

Please note Hotel info can be added to this form at check-in just before your first game

 

Any questions please call Mike Ameen @ 413-281-0174, email KAmeen2128@aol.com