2005 Area 7 Championship Registration
Please fill out this form and send it with your check to:
Checks payable to: Bob Urban - Area 7 Championship
USPSA Area 7 Champshionship
Rob Boudrie
P.O. Box 370
Ashland, MA 01721-1810
This form does not do on-line submission. Please fill in the blanks, print out the form and submit with your check. If you prefer a form you can fill in with a pen, visit the
match ad
.
Name:
Member Number:
Email:
Address:
City:
State:
Zip:
Phone:
Division:
Select a division
Open
Limited
Limited 10
Production
Revolver
Power Factor:
Major
Minor
Lady:
No
Yes
Age:
Junior
Senior
Super Senior
Regular Adult
Entry fee ($100 regular, $50 junior) :
$100 Regular Member
$50 Junior Member
Late fee ($15 after May 22, 2005):
None
$15 Late fee
Optional donation to Jr. Program:
T Shirts @ $15 each
T Shirt Size
Select
Small
Medium
Large
X-Large
XX-Large
Other comments: