Junior Convention Registration Form

 

Name _________________________________________ Birth Date _______________ Male __ Female __

Home Address __________________________ City ________________ St. ___ Zip Code ______________

Home Phone _______________ School Phone _______________ Emergency Phone _________________

School Name ___________________________________________ Customer Number _________________

School Address _________________________ City_________________ St. ___ Zip Code ______________

 

Events Entered: (Please include event numbers from Jr. Convention Guidelines)

  1. ________________________________________________________________________________

    2.  

  2. ________________________________________________________________________________

    3.  

  3. ________________________________________________________________________________

    4.  

  4. ________________________________________________________________________________

    5.  

  5. ________________________________________________________________________________

    6.  

  6. ________________________________________________________________________________

    7.  

  7. ________________________________________________________________________________

    8.  

  8. ________________________________________________________________________________

    9.  

  9. ________________________________________________________________________________

    10.  

  10. ________________________________________________________________________________

    11.  

  11. ________________________________________________________________________________

    12.  

  12. ________________________________________________________________________________

 

I certify as the sponsor of the above student that I have checked his/her registration and events.

 

 

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Sponsor’s Signature