July 23-24 Cleveland, Ohio
(Early Registration Deadline July 28, 2011)
Name of Event for Boys and Girls: __________________________________________
Team Name: _____________________________________________
Contact Name: ___________________________________________
Address: ________________________________________________
City: ____________________________ State: _______ Zip: _______
Tel No: _____-__________________ Cell NO____-_______________
Email: __________________________@_______________________.com
Print this form out
Then Send this form and
Make Checks payable to
OYBA
C/O Next Level
1410 W 9th Street
Lorain, Ohio 440-52
for Information call .440 574-1832 Douglass Rose * 330 245-8109 Reggie Floyd
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.5th Annual Adidas Grassroots National Championship Finals $350 Before July 15, 2011, $475 After
.boys and girls teams
National Showcase
