REBELS REUNION REGISTRATION FORM

Name: ____________________________
Address: ____________________________
Address: ____________________________
City/Town: ____________________________
Postal Code: ____________________________
Years Played: ____________________________
Team Captain: ____________________________
$20 Payment Enclosed:
Cheque:
Money Order:

Mail Completed Form to:

Basketball Reunion
Box 587
Inverness, NS,
B0E 1N0



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