Team Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

     
       Name of Venue _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

     
       Venue Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    
        _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    
    
        Secretary Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
     
    
       Secretary Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    
        _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
    
        _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

    
        Email Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

    
       Tel No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
 

       
       Names of Team Members                                                                       Dates for Home Games if Required
       
       1. _______________________     7.____________________________                 1. _____________
       
       2. _______________________     8.____________________________                 2. _____________

       3. _______________________     9.____________________________                 3. _____________

       4. _______________________   10.___________________________                   4. _____________

       5. _______________________   11.___________________________                   5. _____________

       6. _______________________   12.___________________________                   6. _____________

      Registration £25 per Team (Payable to Mendip League SMBA)                                      7. _____________
    
     Return to Andrew Church, Winders Cottage, Wards Silk Mill, Queens Rd, Evercreech, Shepton Mallet, Somerset,   BA4 6JR