2010 Caribbean Classic Gymnastics Meet

February 27 – 28, 2010

USA Registration Form

Team ____________________________________________________________ Club number __________________________

 

Street Address ________________________________________________ City _____________________________________

 

State __________ Zip ________  E-Mail _____________________________________________________________________

 

Day Phone _____________________ Evening Phone _______________________ Fax ____________________________

 

COACH _________________________________USAG # ______________ Safety Cert. Exp ____ T-Shirt Size _____

 

COACH _________________________________USAG # ______________ Safety Cert. Exp ____ T-Shirt Size _____

 

Copy as needed.  Please list by age group – one level per page.  Please Print Clearly

Age determination dates:  Determined by State meet.

 

Gymnast Name

Level

Birthday

Age

Age Group

USA#

US Citizen

Y/N

T-Shirt Size

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of Gymnasts:         USA 2-6                      _______ x $55   = ____________

                                                USA 7-10, PREP         _______ x $65   = ____________

Team Fees:                                                               Per Team $35 = ____________

Payable to SEGA Booster Club:                             Total Fee        = ____________

Mail entry form and check to:       Southern Elite Gymnastics Academy

c/o Eleanor Joubert

DEADLINE:                                         325 Henderson Parkway

Must be postmarked by       Alpharetta, Georgia 30004

February 1, 2010                       For further details visit us at www.segagymnastics.com or

                                                                        www.leaguelineup.com/segaboosterclub

For questions please contact Robyn Mitchell at (404) 518-3093, Angela Hunte at (404) 808-3451

 or  SEGA at (770) 777-0199    866-552-8803 Fax number