ANTONIA AGOSTINELLI MEMORIAL TOURNAMENT "*" indicates required fields Team Name* Division* 13U ($950) 14U ($1000) 15U ($1100) 16U ($1200) 17/18U ($1300) What city and state is your team from?* Coach* Coach's Email (to receive Tournament updates)* Coach's Home Phone*Cell Phone* Alternate Contact/Coach* Alternate's Email (to receive Tournament updates)* Alternate's Home Phone*Alternate's Cell Phone*Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Special Request (i.e. preferred dates/times) - may not be honored, but considered.Total Charges Price: $0.00 Questions: info@salsbaseball.com or 631 979-0528 PDF of form
