| Print this form and fill in the size brick you would like. Payment must accompany all orders. Make checks payable to Roseville Jr. Sports, Inc. Bring to the Roseville Junior Sports, Inc. Complex @ 29700 Pinehurst or mail to: Roseville Jr. Sports, Inc. P.O. Box 194 Roseville, MI 48066-0194 |
| 4 X 8 brick @ $40.00 |
| 8 X 8 brick @ $90.00 |
| PLAYER NAME:____________________ PARENT:____________________ PHONE:____________________ PAYMENT: check cash |