Blacklight Dodgeball

GASSETT AFTER DARK - BLACKLIGHT DODGEBALL

Friday, January 17

Check-In begins at 7 pm, event starts at 8 pm!

Teams of 6-10 people will compete under the glow of the blacklight to determine the champion! Neon t-shirts and glow materials will be provided. Guests over 18 are free with valid photo ID.

If you don't have at least six players, you can register yourself and/or any other players and we will help create your team!

ClipperCard required for entry.

Team Name *

Team Captain - First Name *

Team Captain - Last Name *

Please provide t-shirt sizes for all team members. Number of shirts requested must match number of registered players. *

	Small	(15 remaining)
	Medium	(58 remaining)
	Large	(75 remaining)
	XL	(35 remaining)
	XXL	(15 remaining)
	XXXL	(5 remaining)

Phone Number *

Salem State Email Address *

Salem State Affiliation: *

Student

Employee (Faculty/Staff/Administrator)

Student or Employee ID# *

Player 2 First Name

Player 2 Last Name

Player 3 First Name

Player 3 Last Name

Player 4 First Name

Player 4 Last Name

Player 5 First Name

Player 5 Last Name

Player 6 First Name

Player 6 Last Name

Player 7 First Name

Player 7 Last Name

Player 8 First Name

Player 8 Last Name

Player 9 First Name

Player 9 Last Name

Player 10 First Name

Player 10 Last Name

Please provide a brief statement as to how this offering will impact you/your wellbeing and/or your sense of connection and belonging *

How did you hear about this program/event? *

Guests outside the SSU community are invited to participate in this event as long as they are at least 18 years of age with a valid photo ID. *

I have read and shared the above information with all guests