ADA League Registration Form

ADA League Registration Form
League Format*
Day of League Play*
Team Name*
Board Information
Board/Home Location*
Board Number/ID
Board Serial Number*
Board POC
Board POC Phone Number

Area CodePhone Number
ADA Area Information
ADA Area*
State*
ADA Rep Name*

First NameLast Name
ADA Rep Email*
example@example.com
If you are outside of the 221 Area you must have your local ADL Representative concur with your participation in this league. You must have local rep sign along with the host location sponsor. Forms located at the end of this application. Return signed form to HDye@adadarters.com
Host Location Information
Name of Host Location*
Address of Host Location*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
POC at Host Location*
Email of POC at Host Location*
example@example.com
Phone Number of Host Location*

Area CodePhone Number
Sponsor Fees: Sponsor fee (host location) is required. Please verify with host location (includes home board users). Sponsor fees will be invoiced direct to host location.
Team Captain
Captain:*

First NameLast Name
E-mail*
Paypal Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Radikal ID #:*
ADA #:*
Additional Players
Player #2:

First NameLast Name
Email:
example@example.com
Phone Number:

Area CodePhone Number
Radikal ID #:
ADA #:
Player #3:

First NameLast Name
Email:
example@example.com
Phone Number:

Area CodePhone Number
Radikal ID #:
ADA #:
By submitting this registration form I agree to abide by ADA Rules and local 221 Bylaws. Your local ADA Rep must verify that you are in good standing with ADA.
221 Area Manager: Jesse Beach (571) 221-5576; jessebeach82@gmail.com

221 National Capital Region Owner/Rep

Holly Dye (703) 350-2915

hollyadye@gmail.com hdye@adadarters.com

www.adadarters.com

www.extremedarts.net

Required ADA Registration Forms:
Should be Empty:

ADA League Registration Form

Board Information

ADA Area Information

Host Location Information

Team Captain

Additional Players