Prairie State Shootout Registration

PRAIRIE STATE SHOOTOUT REGISTRATION FORM

A printable version of this form can be found here.

Please remit printed forms to:

B-PC Prairie StateShootout
Bushnell-Prairie City High School
845 North Walnut Street
Bushnell, IL 61422

School Name:
Coach's Name:
School Phone:
Home Phone:
Fax Number:
E-Mail:
Roster Position 1:
Roster Position 2:
Roster Position 3:
Roster Position 4:
Roster Position 5:
Roster Position 6:
Roster Position 7:
Roster Position 8:
Roster Position 9:
Roster Position 10:
May we use pictures of your team as part of our website?	Yes No
I have read and agree to abide by the stated Prairie State Shootout rules.	Yes

Shootout rules can be found here.

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