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        $ …….

Late Fee Assessed After April 22, 2006                                                        

TOTAL AMOUNT FOR TOURNAMENT  …………………………………………… $ _________

 

EVENT

Check Event Entering

Weapon Classification Letter & Date

National Points Earned

W FOIL

 

 

 

W EPEE

 

 

 

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.                                       

NO ENTRIES ACCEPTED AFTER APRIL 29.  Make Checks Payable To: Philadelphia Division, USFA. Mail Entries To: Rosemary Turunc, 220 Victoria Ct., Doylestown, PA 18901  

 

PLEASE NOTE: THE ONLINE REGISTRATION FOR THIS EVENT IS AT “askfred”

 

www.askfred.net

 

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.                                               

 

____________________________________                       _____________________________________

Fencer’s Signature                                                                Parent / Guardian ( If Under 18 )