2023NCHolidayHoopsRegistration

NC Basketball Boosters Holiday Hoops Shootout 2023

REGISTRATION DEADLINE DECEMBER 8, 2023

QUESTIONS PLEASE CONTACT AMY MOLENDA AT AMOLENDA@ZOOMINTERNET.NET

Name*

First Name

Last Name

Organization Name*

Email*

Phone*

Number of Teams Registering from your organization*

First Team Information

Team Name (1st Team)*

Team Division (1st Team)*

Contact (1st Team)*

First Name

Last Name

Cell Phone (1st Team)*

Email Address (1st Team)*

Second Team Information

Team Name (2nd Team)*

Team Division (2nd Team)*

Contact (2nd Team)*

First Name

Last Name

Cell Phone (2nd Team)*

Email Address (2nd Team)*

Third Team Information

Team Name (3rd Team)*

Team Division (3rd Team)*

Contact (3rd Team)*

First Name

Last Name

Cell Phone (3rd Team)*

Email Address (3rd Team)*

Fourth Team Information

Team Name (4th Team)*

Team Division (4th Team)*

Contact (4th Team)*

First Name

Last Name

Cell Phone (4th Team)*

Email Address (4th Team)*

Fifth Team Information

Team Name (5th Team)*

Team Division (5th Team)*

Contact (5th Team)*

First Name

Last Name

Cell Phone (5th Team)*

Email Address (5th Team)*

Sixth Team Information

Team Name (6th Team)*

Team Division (6th Team)*

Contact (6th Team)*

First Name

Last Name

Cell Phone (6th Team)*

Email Address (6th Team)*

Payment

Quantity

Sub-Total* $

Total to Charge* $

Name on Credit Card*

First Name

Last Name

Credit Card*

Card Security Code*

The card security code is located on the back of MasterCard, Visa and Discover credit or debit cards and is typically a separate group of 3 digits to the right of the signature strip.

Expiration Date*