MID-ATLANTIC SECTIONAL CHAMPIONSHIPS
2006 SENIOR
ENTRY FORM
Last Name (Print As
It Appears On Your USFA Card)
First Name USFA #
Club
Division Phone
Address
City
State Zip
DATE OF BIRTH
________________ E-MAIL
_________________________________________
REGISTRATION FEE FOR
ALL FENCERS $ 30.00
$ 30.00
ENTRY FEE FOR EACH
EVENT $
30.00 times number of events $
.
LATE FEE FOR EACH
EVENT $ 30.00
times number of events $
.
|
EVENT |
Check Event
Entering |
Weapon Classification
Letter & Date |
National Points
Earned |
|
W FOIL |
|
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|
W EPEE |
|
|
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|
W SABRE |
|
|
|
|
M FOIL |
|
|
|
|
M EPEE |
|
|
|
|
M SABRE |
|
|
|
Enclose A Stamped
Self-Addressed Envelope Or Provide Your E-Mail Address Above For Confirmation
Of Entry. Entries Must Be Received By April 22, 2006. Late Entries Will Be
Accepted Until April 29, 2006 With Penalty Fee.
PLEASE NOTE: THE
ONLINE REGISTRATION FOR THIS EVENT IS AT askfred
WAIVER OF LIABILITY:
Upon entering this event under the auspices of the USFA, I agree to abide by
the rules of the USFA. I understand that participation in sport carries a risk
to me of serious injury, including paralysis or death. My heirs and I accept
and assume this risk and release the USFA, sponsors, event organizers and
officials from any liability.
____________________________________
_____________________________________
Fencers
Signature
Parent / Guardian ( If Under 18 )