Team Name:

Gym Jam

Team Fee Paid:

YES (Sponsor)

Qualify for

LAST NAME

FIRST NAME

Method of Indivdual Registration

Minor Under 18yrs

Wrist band

Event T-shirt ($100)

Date Shirt was Picked Up

Shirt Size

Free Lunch ($100)

Free Dinner ($100)

CHECKS/CASH

ON-LINE

GRAND TOTAL

Acuna-Stein

Ernestine

Member

Online

Yes

No

L

No

No

$                     -

$                     -

$                     -

Bacchus

Ilse

Member

Online

Yes

Yes

5/22/2010

S

Yes

Yes

$      40.00

$              40.00

$            200.00

$            240.00

Chan

Kathleen

Member

Online

Yes

No

5/22/2010

XL

No

No

$                     -

$            100.00

$            100.00

Hansen

Debbie

Member

Online

Yes

No

XL

No

No

$                     -

$              25.00

$              25.00

Hansen

Sydney

Member

Online

Yes

No

S

No

No

$                     -

$              25.00

$              25.00

Harries

Gabriel

Member

Online

Yes

No

L

No

No

$                     -

$              50.00

$              50.00

Harries

Joe

Member

Online

Yes

No

L

No

No

$                     -

$              50.00

$              50.00

Harries

Sally

Member

Online

Yes

No

3XL

No

No

$                     -

$              60.00

$              60.00

Harries

Thomas

Member

Online

Yes

No

YL

No

No

$                     -

$              50.00

$              50.00

Shochet

Darlene

Member

Online

Yes

Yes

5/22/2010

M

Yes

Yes

$                     -

$            625.00

$            625.00

Steele

Cheryl

Member

Online

Yes

Yes

5/22/2010

2XL

Yes

Yes

$                     -

$            100.00

$            100.00

Waller

Cindy

Captain

Online

Yes

No

M

No

No

$                     -

$              50.00

$              50.00

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

GENERAL DONATIONS

$                     -

$                     -

Registration Overpay

$                     -

$                     -

Corporate Sponsor

$                     -

$                     -

Day Of - Team Raffles

$                     -

$                     -

Day Of -Booth Sales

$                     -

$                     -

12

3

3

3

$      40.00

$             -

Count of team members

12

Total # of bands

Total # of shirts

Total # of lunch

Total # of dinner

Relay

22-May-10

$              40.00

$         1,335.00

$         1,375.00

Entry # 1

Entry # 2

(Checks/Cash)

(On-Line Only)

Total to Date

Gym Jam