Sponsored by PCMS PTO
Wednesday, April 5, 2017 from 3:00-5:00 at the PCMS gym
Opened to all PCMS students and incoming 6th graders
Entry fee: $5 per player Checks payable to PCMS PTO
Concessions will be available for purchase including Casey’s Pizza.
• Non-participants/Spectators: Free will cash donation or a donation for the school Treasure Chest
(Personal care items (toiletries, diapers, etc.) Shelf-stable food, Laundry and dishwashing soap.
Teams may have 10 or fewer players.
**Teams may be made up of any grade level or co-ed.**
Each player must turn in a permission form.
*Turn in all team forms
TOGETHER as a team to the office!
All forms due Monday, April 3, 2017
-------------------------------------------------------------------------------------------------------------------Team Name: _______________________________________________
Team Members:
1.
6.
2.
7.
3.
8.
4.
9.
5.
10.
Your parent or guardian must sign below for you to participate.
____________________________ has my permission to participate in the PCMS Dodge ball
Tournament. I understand there is always a risk with a sporting competition and my signature releases
PCMS, PCMS PTO, tournament directors and sponsors from any liability in case of an injury.
__________________________________
Parent Signature