Team Membership Application
For 2012-2013

*required fields

Team Info.

*Team Name:
*Team History:	New Team Returning
	Previous season Upper School Team IEA#: (if known/applicable)
	Previous season Middle School Team IEA#: (if known/applicable)
*Facility Location: (for listing on IEA website)	Street Address:
*Facility Location: (for listing on IEA website)	City: State: Zip:
*Team Registration(s): (multiple selections allowed)	Hunt Seat Upper School ($125) Hunt Seat Middle School ($125) Hunt Seat Upper & Middle School ($175) no Hunt Seat (clear) Western Upper School ($125) Western Middle School ($125) Western Upper & Middle School ($175) no Western (clear) Saddle Seat Upper School ($75) Saddle Seat Middle School ($75) Saddle Seat Upper & Middle School ($100) no Saddle Seat (clear)

Coach Info.

*Coach Name:	First: Last: (primary contact)
*Coach History:	New Member Returning, IEA Number: (if known)
*Team Phone Number:	(including area code)
*Coach Email Address:

Contributing Member Access (optional)

Only the following Contributing Members have administrative privileges to the team information and communications:

Name:
Phone Number:	(including area code)
Email Address:

Name:
Phone Number:	(including area code)
Email Address: