"CLUB" NAME:__________________________________


CONTACT NAME:________________________________


E-MAIL:_________________________________________


CLUB'S HOME CITY______________________________


APPROX # OF MEMBERS IN CLUB__________________
SMALL=LESS THAN 10 MEMBERS
MEDIUM= 11-49 MEMBERS
LARGE= 50+ MEMBERS

FORWARD THIS TO:

Kevin@midwestmultisport.com
1786 W. Wayzata Blvd.
Long Lake, MN 55356
952-473-0093