ILLINOIS NSA OFFICIAL TEAM TRAVEL PERMIT
Any ILLINOIS NSA YOUTH TEAM that wishes to participate in NSA Tournaments outside the state of ILLINOIS needs to fill out this form, and submit to the NSA State Office no later than 30 DAYS prior to the tournament. Please fill in this form, print off and mail to: Bob Biehl, Youth Director P.0. 3812 Champaign, IL 61826
DATE of Request: _____________________________
MY TEAM WISHES TO PARTICIPATE IN THE FOLLOWING NSA TOURNAMENT:
Tournament Name: ______________________________________________________________
Tournament Date: ____________________________________________________________________________
Tournament Location __________________________________________________________________________
Tournament Director: __________________________________________________________________________
Please Select: AGE 8u 10u 12u 14u 16u 18u 20u
CLASS A B
TEAM INFORMATION
NSA Team Registration Number: ____________________________________________________________
Team NAME: ________________________________________________________________________________
Manager Name: ______________________________________________________________________________
Phone: (Day) ____________________ Phone: (Night) ____________________ Fax: ______________________
E-mail: ____________________________________________________________________________________
I acknowledge
that my signature as team representative verifies that I will take an extra Copy
of my Official NSA Online Roster, complete with all signatures AND an extra copy
of my insurance CERTIFICATE to leave at the tournament site. I understand that
my team will not be allowed to participate without them. I also understand that
these copies will NOT be returned to me at any time.
Managers Signature: _____________________________________________________ Date: _____/_____/_____
Send copy to: Bob Biehl Phone: 217-356-0244
NSA Illinois State Fast-Pitch Director
P.0. 3812 E-Mail: bobbiehl@sbcglobal.net
Champaign, IL 61826
The
NSA Illinois State Fast-Pitch Director will review this form. The Form will be
forwarded to the Tournament Director. After the Travel Permit is received in
office, it will take no less than one week to reply. After one week, please feel
free to contact us via e-mail. Thank you!
Signature of NSA Director: ___________________________________________________ Date: _____/_____/_____
NOT VALID WITHOUT NSA DIRECTOR’S SIGNATURE - DIRECTOR FORWARD TO STATE OFFICE
www.illinoisnsa.com