Pre-registration must be submitted no later than July 1st.
* Team Name
* Team Captain
Team Roster:
* (1)
* (2)
* (3)
* (4)
* (5)
* (6)
* (7)
* (8)
Team Captain Contact Information:
* Mailing Address
Apt/Suite/Unit
* City
* State
* Zipcode
* Contact Phone
* Email
Entry Fee - $40.00
Make checks payable to ICCI - 4th of July. Mail your check for the total amount to:ICCI - 4th of JulyAttn: Linda KressP.O. Box 366Independence, Iowa 50644For more information, please call 319-327-1070 or 319-935-3000 x1010
ICCI - 4th of JulyAttn: Linda KressP.O. Box 366Independence, Iowa 50644For more information, please call 319-327-1070 or 319-935-3000 x1010
* Verification Code
