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You would like for your team to participate? Its easy, just click on Contact Us and let us know you are interested. We will contact you and do the rest.

Let's go Team!

Team Participant Information Form
School Name
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Address
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City/State/Zip
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Phone
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Email *
Input must be a valid email address
Principal/Headmaster/President Name
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Head Football Coach Name
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email
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# of Coaches
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Coaches’ shirt sizes
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# of players & mgrs
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Cheerleader Coach Name
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email
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# of cheerleaders
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Contact Person/Tackle-a-Cure coordinator
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email
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October Home Game “Pink Out” date: 1st choice
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2nd choice
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You will receive your Tackle-a-Cure items the beginning of the week of your game. Please feel free to continue using the items the entire month depending on your home game date.

PLEASE RESPOND BY RETURNING THE CONTACT INFORMATION FORM IN BY AUGUST 1, 2012. RETURN THE FORM TO 2550 FLOWOOD DRIVE, SUITE 200 FLOWOOD, MS 39232 OR VIA FAX 601-939-0590 - ATTENTION “TACKLE-A-CURE COORDINATOR”. PLEASE COMPETE THE FORM AS MUCH AS POSSIBLE; HOWEVER, WE DO KNOW SOME THE INFORMATION REQUESTED COULD BE SUBJECT TO CHANGE.

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