Name _________________________________

Phone (_____)___________________

Address ___________________________

City ___________________ State _____ Zip ______

Club ______________________________

Email  * ________________________

Please indicate classification(s) (eg, U, E06, etc.) for weapons you are entering:

Épée _______

Foil _______

Saber _______

Show events you are entering (Yes):

Men’s Épée

__________

Women’s Épée

__________

Men’s Foil

__________

Women’s Foil

__________

Men’s Saber

__________

Women’s Saber

__________

Events your team is entering (Yes):

Mixed Épée

__________

Mixed Foil

__________

Mixed Saber

__________

Registration    $20

$_________

(Add $10 if not pre-registered for an individual event before the tournament)

Each event   $10 per event

$_________

Each team   $30 per team (no additional charges)

$_________

Amount due

$_________