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Online Registration
Form
Please
fill in all fields marked with a * or you may receive an
error page. |
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Team
Name
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*
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Contact
Name
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*
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Full
Mailing Address
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*
example: 1622 Mulberry Drive,
Lake Villa IL 60046 (Don't Forget City, State, Zip)
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Phone Number
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*
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Email Address
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*
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Additional Email Address
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Team & Event Information |
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Competition Name & Date
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# of Teams
*
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Team 1 Division
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#
of Athletes
# of
Crossovers
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Team 2 Division
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# of Athletes
# of
Crossovers
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Team 3 Division
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# of Athletes
# of
Crossovers
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Team 4 Division
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# of Athletes
# of
Crossovers
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Team 5 Division
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# of Athletes
# of
Crossovers
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Team 6 Division
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# of Athletes
# of
Crossovers
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Team 7 Division
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# of Athletes
# of
Crossovers
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Team 8 Division
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# of Athletes
# of
Crossovers
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Total # of Athletes
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Total #
of Crossovers
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Select Pricing |
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Calculate Total Fee |
Total # of Athletes x Current Pricing
= _____
+
Total # of Crossovers x 1/2 of Current Pricing =
_____
$ |
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Payment Information: |
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Credit
Card
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*
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Credit
Card Number
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*
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Name
On Card |
* |
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Expiration
Date
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*
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3
Digit Code on Back of Card
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*
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Special
Instructions or Information
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Name
of Rep
if Applicable
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