REGISTRATION FORM for 2003 NATIONALS

School/Team ____________________________________________

Division Circle one: Collegiate - Open

Contact Person _____________________________________________________ circle: Coach - Captain - Manager

Preferred Phone (_____)__________________ Other Phone (work, cell, etc.) (______)____________________

Fax (______)____________________

MUST SUBMIT : eMail address _____________________________________

Home Address ______________________________________________________________________

City ___________________________________________ Province __________________________

Postal Code _______________________

Registration Fee is $15.00 per Athlete and Coach.

Number of Athletes Competing:___________ x $15.00 = ___________

Number of Coaches/Trainers/Managers __________ x $15.00 = ___________

Total Entry Fee: ___________

*Teams may have any number of athletes on the floor (ie you are not limited to 20)*. Injured/non-competing and "JV" team members must also have a pass tag or event ticket for entry to the Hershey Centre. These members are NOT required to submit eligibilty information unless there is a possibility that they may be inserted into the competing unit after the deadline.

All Paid Entries with Verified eligibility forms must be received AT the PCA Office no later than Wednesday October 22.

Applications and forms received between October 22 and November 11 will be assessed a $50.00 late fee.

Applications and forms received after Wednesday November 12 will be assessed a $100.00 late fee.

NOTE: Changes to team numbers and/or additions/deletions are not subject to "late" fees. Coaches and team managers are responsible for having all documentation completed and in to the PCA office on time.

| Print: Eligibility Information Form PDF or GIF |

*Please photocopy this form and keep for your records.

Entry Fee Payment cheques are Payable to PCA or Power Cheerleading Athletics. We do not accept P.O.'s or Credit Cards.

Receipts for fees will be handed out to coaches/managers at the coaches meeting prior to the competition start on Nov. 22.

Mail Entry fee and form to

Power Cheerleading Athletics

3 Horn St. London, Ontario. N6C 3K3

FAX: (519) 434-9531 NOTE: Application is not valid until entry fee is received.

Questions: 1-800-567-7221

eMail: PCA@powercheerleading.com