BOARD OF DIRECTORS
Adult Chair
Jason Blunk
Reid Hospital
Youth Chair
Alison Weaver
Student – Centerville H.S.
Secretary
Cassie Miller
Student- Centerville H.S.
Your child has signed up for the Kick Butts Kick Ball Tournament. Here is the
information for the event:
Date: Friday, April 8, 2016
Event Time: 4:30p-7:30pm
Where: Centerville High School West Gym Tournament Prizes:
Adult Treasurer
Judy Miller
Wolverine Worldwide
Prizes will be awarded for 1st, 2nd,3rd place
Team Cost: $5 per player for 7-10 players
General AdmissionCost: $1
Youth Treasurer
Claire Linginfelter
Student- Seton H.S
Lisa Felsman
Centerstone
All proceeds will be donated to “Relay For Life” from the Centerville Voice Club
Contact: Tammy Cornell @ [email protected]
Teams can sign up during lunches or with Mrs. Hinshaw. You will receive a gained
knowledge of how to fight back against Big Tobacco, a ticket voucher for an item
from concessions as you enter, chances to win cool prizes. Adult Form
Ashley Stephen
Early Head Start
Hollie Day
Centerstone
Rita Gentry
Striderite
Brandon Gentry
Student- Richmond H.S.
Paul Turner
Student- Hagerstown H.S.
“As a participant of the event, I grant my authorization and consent for to be
photographed and video-graphed for YAR to share with the community. I further
consent to and authorize the reproduction, publication, and use by Youth As
Resources and assigns, for advertising, commercial, or any other purposes, of any
photograph, picture or likeness of the previously named participant.
I hereby agree not to hold Youth As Resources of Wayne County, their fiscal
agency, Centerstone of Indiana, Centerville-Abington Community Schools or the
organization’s other partners or sponsors liable for personal injury, lost, stolen,
and or damaged property to, from, or by my child.
My signature below indicates I have thoroughly read the information on this
form and I agree and accept these provisions. Furthermore, I affirm that the
information I provided is true to the best of my knowledge.”
Please sign below and return this paper by the day of the event so that your child
may participate in the competition.
Adult Name___________________________________________
Kirsten Baldwin
Student- Richmond H.S.
Maddie Day
Student- Centerville H.S.
Adult Signature_______________________________Date: ______
Youth As Resources P.O. Box 94 Richmond, IN 47375
765-969-5121 [email protected]