Name: ____________________________________ Date: __________________________
Address: _________________________________ Phone: ( ) _________________
City: ____________________________________ Zip _____________ Country: _____
Address Change? N Y Sex: F M Birthdate: ___/___/___
Shirt Size S M L XL
WFA Member? N Y Member #____________ Status: Amateur Pro
Have You Ever Competed at Worlds?: N Y
Club Affiliation: ________________________
EVENTS
Please circle the appropriate level for each event you want to compete in
and the name of your partner if applicable.
NET EVENTS
SINGLES
Open Women's Open Men's Intermediate Women's Intermediate
DOUBLES
Open Women's Open Intermediate Partner's Name: ________________
Mixed Doubles Partner's Name: __________________
FREESTYLE EVENTS
Singles Open Women's Open Intermediate
Doubles Open Women's Open Partner's Name: ________________
Mixed Doubles (no $) Partner's Name: __________________
Preferred Judging Assignment:
1st choice ___________________ 2nd choice ____________________
Choices: X-Body/Body/Dexterity/Delay/Unusual/Presentation/Team/Adds/Contacts
OTHER EVENTS
Golf Open Women's Open Intermediate
5-Minute Singles Open Women's Open
Timed Consecutive Open Women's Open List Your Best Score ___________
Doubles Distance One-Pass Open Women's Open Partner's Name:_____________
EVENT FEES (U.S. dollars)
Tournament Entry Fee:
Pro - $60.00 or Amateur - $25.00 $_____________
Number of open/women's open events entered ____ x $5.00 = $_____________
Number of intermediate events entered ___ x $3.00 = $_____________
Late registration fee add $10.00 $_____________
Postmarked after July 2, 1997 for International competitors and
July 12, 1997, within the U.S.
SUBTOTAL $_____________
If you are a scholarship winner, please indicate which approved tournament
awarded you this scholarship. You must meet the pre-registration deadline
to receive your scholarship.
Scholarship awarded by: ___________________________________
International Incentive Program: please complete this form if you are
coming to the World Championships as part of this program. You must confirm
your travel plans with Sole Purpose by May 1st and mail this form to Sole
Purpose by July 2, 1997.
OTHER FEES NOT INCLUDED IN SCHOLARSHIP OR INCENTIVE PROGRAMS:
Please circle amount you are including with your registration fees and
add to total:
Lunch Tickets for Monday 8/10/97 through 8/15/97 $15.00
Booster Club Entry Fee $150.00
Hall of Fame Silver Anniversary Black Tie Affair $50.00
Hall of Fame ages 13-16 $35.00
Pioneers of Footbag pre-registration $2.50
GRAND TOTAL $ ________
WAIVER FOR PARTICIPATION:
I, ______________________________, hereby wish to enter the 1997 World
Footbag Championships at its set and agreed upon entry fee. I understand
that this entitles me to participate in all events entirely at my own risk
and cost. I also vow to conduct myself in such a manner that is within the
guidelines set forth by the World Footbag Association (WFA) and Sole Purpose
Footbag Club. I understand and hereby authorize the WFA and Sole Purpose
Footbag Club to use any and all film and video tape taken of me during this
event, to be used for any purpose. In consideration of your accepting my
(my childís) entry, I hereby, for myself (my child), my heirs, executors
and administrators, waive and release any and all rights and claims for
damages I (my child) may have against the WFA, Kendall KIC, Sole Purpose
Footbag Club, adidas, Pastime Sports, the City of Portland, Portland Park
and Recreation Department and its representatives, successors and assigns
for any and all injuries suffered by myself (my child) at any activity
sponsored by these groups.
_____________________________ ________________________________________
Signature Guardian or Parent if under 18 years old
Print out, fill in, and mail this registration form with check payable to:
Sole Purpose Footbag Club
1805 S.E. Marion Street
Portland, Oregon 97202-7351
USA
For More Information, call: Kendall KIC, (503) 236-0939, or E-mail: worlds@footbag.org http://www.footbag.org/worlds/