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Contact Position:
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Contact (First Name):*
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Contact (Last Name):*
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School City:*
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State:
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Zip:
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(123.456.7890)
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Home City / State / ZIP:
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(123.456.7890)
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Send Correspondence To:
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(123.456.7890)
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Specify if "Other":
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# of Judges Needed:
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Additional Programs (optional):
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| ** |
[due to USA events & staff workshops, some dates may not be available]
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| Event Date:* |
[MM/DD/YY]
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Report Time:* |
[usually 30 min before start]
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| Start Time:* |
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End Time:* |
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| Meeting Location:* |
[e.g., gym, dance room, etc.]
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Do you need Social Security Numbers? |
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Camp attended
in 2011? |
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If USA, are you a
VIP member:
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Are you registered
for a 2012 camp?:
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If so, which camp
are you planning
to attend?:
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| Date: |
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Location: |
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of its kind in the western
