Team/Club Information

Club Name *
Team Name
Team Location
Club/Team Twitter Handle
Team’s Grade

Coach’s Information

Coach’s Name
Coach’s Email
Coach’s Phone
Coach’s Mailing Address

Travel Information & Special Requests

Check all that apply: Staying Friday Night
Staying Saturday Night
Special Requests:

Please enter the text in the graphic below:

Payment Information

Payment Information:

  • Cost is $375 per team and must be paid prior to a team being scheduled for tournament games.
    • $350 per team if registering¬†‚Č•3 teams
  • You may complete payment via Paypal (3% convenience fee added) after submitting the form, or make check payable to Mid-Penn Motion and mail to:
    P.O. Box 622
    Camp Hill, PA 17011.