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City of Richardson
Corporate Challenge

Division B

Richardson city logo

2017 Dominoes Roster for Mapei

The undersigned participants release the City of Richardson, Texas, (it's officers, agents and employees) from any injuries or damages sustained as the result of the participation in Corporate Challenge. By the signature below the undersigned participants acknowledges that the undersigned has read and understands the Corporate Challenge rules and agrees to abide by them.

Captain
Last Name First Name PhoneEmail
Somabut Bob 2145356017

Team 1
  Last Name First Name Gender Status Signature
1 Danyel Tatum Male Employee  
2 Faulkner Brandon Male Employee  

Team 2
  Last Name First Name Gender Status Signature
1 Car Derris Male Employee  
2 Mercado Jason Male Employee  

Substitutes
  Last Name First Name Gender Status Signature
1 Perez Mario Male Employee  
2 Piatek Robert Male Employee