ࡱ > bjbjaa I [ : r r r r r 8 4 t , f f | | | $ $ $ + + + + + + + , #. 0 d + r $ F$ F$ ^ $ $ + l% r r | | + l% l% l% $ R r | r | + l% $ + l% l% : * , * О $ v * + + 0 , * 91 l% 91 * l% * r * $ $ $ + + l% $ $ $ , 91 $ $ $ $ $ $ $ $ $ 8 : 2016 Alamo Classic Entry Form Attending Clubs Name: USAG Club # Street Address: Phone # City: State: Zip: Fax #: Attending CoachUSAG #USAG ExpSafety ExpBackground Exp Entry & Payment Deadline: Nov. 1, 2015 (late entries $20 per athlete); Refund Request Deadline: Nov. 27, 2015 Level Changes Deadline: Nov. 27, 2015; Substitutions after Nov. 27, 2015 are subject to a $20 late fee per entry USA Gymnastics Athlete and Coaches Roster MUST accompany Entry Form Separate sheet per Level requested - List by D.O.B. Youngest to Oldest First Name (typed) Last Name (typed) Level USAG # DOB Leo size YS, YM, YL, AXS, AS, AM, AL, AXL Current Senior Y/N? Class of 2016 123456789101112 Meet Directors UseDate Rec'd:Check # :Amount:$Short / Over: _______ Level 1-2 Gymnast X $ 80.00 Entry Fee =$_______ Level 3-5 or Xcel Gymnast X $ 110.00 Entry Fee =$_______ Level 6-10 Gymnast X $ 130.00 Entry Fee =$Level(s) _______ Team X $ 50.00 Entry Fee (per level) = $ TOTAL ENCLOSED $ I understand that this form MUST be in type written form and that I am responsible for the correctness of names, USAG numbers, levels DOB, age groups and other information required on this form. Attach additional forms if necessary. Checks should be payable to AA Parents Association. Contact Coaches Name (typed):Cell Phone # (Required) Contact Coaches Email Address: Signature: Rev. DATE \@ "M/d/yy" 6/4/15 " # $ 2 3 ; > ? @ A B N Q R S a b j p q t v w | ҾҴҜ{r{fr[rr h) h*[= CJ aJ h) h*[= >*CJ aJ h*[= >*CJ aJ h) h*[= CJ h) h*[= >*CJ aJ h) h*[= >*CJ aJ h*[= >*CJ h >*CJ h) h >*CJ h) h*[= >*CJ hm{ 5CJ huR h*[= 56>*CJ h*[= 5CJ hN3 h*[= 5CJ huR h*[= 5CJ h]{ h]{ hw hx$ hO