Louisiana Hemophilia Foundation

“Shoot For A Cure” Registration


Team Captain Information

Name

Email

Daytime Phone

Mailing Address

City

State

ZIP

Parish

If two (2) flights are required to accomodate all of the teams, which time do you prefer?


Team Members Information

Shooter 1

Name

Shirt Size

Email

Daytime Phone


Shooter 2

Name

Shirt Size

Email

Daytime Phone


Shooter 3

Name

Shirt Size

Email

Daytime Phone


Shooter 4

Name

Shirt Size

Email

Daytime Phone