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City of Richardson
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2017 Miniature Golf Roster for BlueCross BlueShield of Texas
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 | Phone | |
|---|---|---|---|
| Lopez | Eric | ||
Men | |||||
| Last Name | First Name | Gender | Status | Signature | |
|---|---|---|---|---|---|
| 1 | Chernov | Allan | Male | Employee | |
| 2 | Correa | Caleb | Male | Employee | |
Women | |||||
| Last Name | First Name | Gender | Status | Signature | |
| 1 | Chavez | Krysta | Female | Employee | |
| 2 | Jeppson | Jaime | Female | Employee | |
Mixed | |||||
| Last Name | First Name | Gender | Status | Signature | |
| 1 | Lopez | Eric | Male | Employee | |
| 2 | Smith | Tonie | Female | Employee | |
Substitutes | |||||
| Last Name | First Name | Gender | Status | Signature | |
| 1 | Archer | William | Male | Employee | |
| 2 | Smith | Peggy | Female | Employee | |