Official Registration Form

Club Name*
Club Number*
Gym Address
Street Address Address Line 2 City State ZIP Code
Gym Phone
Fax
Cell Phone
Coaches
Name USAG# Exp Date Safety Bkgrd
Competitor
Competitor Name Athlete Number Level Birth Date CXS CS CM CL AXS AS AM AL AXL
Competitor 2
Competitor Name Athlete Number Level Birth Date Leotard Size
Entry Fee Summary
Optionals - Fee: $130.00 Per
Gymnasts
Total
Xcel Optionals - Fee: $130.00 Per
Gymnasts
Total
Level 1, 2, 3, 4, 5 - Fee: $120.00 Per
Gymnasts
Total
# Team Entries - Fee: $65.00 Per
(3 scores count per team & level)
Teams
Total
Totals
Total Gymnasts
Total Due

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