24th ANNUAL GASPARILLA CLASSIC ANNUAL GASPARILLA ...

2012 GASPARILLA CLASSIC
USAG SANCTIONED WOMEN’S MEET
AAU SANCTIONED WOMEN’S MEET
Entry Form
Team Name __________________________ Club ID #_______________
Address __________________________________________________
City/ State______________________
Zip _______________
Gym Phone___________________ Gym Fax _______________________
Email Address ________________________________________________
Coaches Attending: USA # Mem. Exp Date Safety Exp Date Background Exp
Date
_____________________ ________ ____________ _____________ _____________
_____________________ ________ ____________ _____________ _____________
_____________________ ________ ____________ _____________ _____________
Please use one form per Level
Circle one: USA Level 2, 3, 4, 5, 6, 7, 8, Fl Xcel (2 divisions), Region 8 Xcel, 9, 10/Open
AAU Level 2, 3, 4, 5, 6, 7, Modified Opt, 8, 9, Ladies
Enter Team Competition? Yes No
Athlete Name USA #/AAU # Age Birthday Level Xcel Division
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Deadline to enter is January 5, 2012
$65/ Levels 2-3, $75/ Compulsory Level 4-6, $95/Optional Athlete $60/Team
MAKE CHECKS PAYABLE TO: LIGHTNING CITY GYMNASTICS
15482 N Nebraska Ave, Lutz, Fl 33549
Do Not Fax this Form