Team Name:

Life Watch Rocks

Team Fee Paid:

Yes

Qualify for

LAST NAME

FIRST NAME

Method of Individual 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

Gerard

Jennifer

Member

Online

Yes

No

M

No

No

$                     -

$              20.00

$              20.00

Guerra

Eric

Member

Online

Yes

No

L

No

No

$                     -

$                     -

$                     -

Ketchepaw

Jenny

Captain

Not on File

No

No

No

No

$                     -

$                     -

Levy

Joey

Captain

Online

Yes

Yes

5/22/2010

L

No

No

$    130.00

$            130.00

$                     -

$            130.00

Minassian

Jena

Member

Online

Yes

No

L

No

No

$                     -

$                     -

$                     -

Minassian

Terry

Member

Online

Yes

No

L

No

No

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

GENERAL DONATIONS

$                     -

$                     -

Registration Overpay

$      10.00

$              10.00

$              10.00

Corporate Sponsor

$                     -

$                     -

Day Of - Team Raffles

$                     -

$                     -

Day Of -Booth Sales

$                     -

$                     -

5

1

0

0

$      10.00

$    130.00

$             -

$             -

Total # of bands

Total # of shirts

Total # of lunch

Total # of dinner

Nov Credit

Relay

Count of team members

6

30-Nov-09

5/22/2010

$            140.00

$              20.00

$            160.00

Entry # 1

Entry # 2

Entry # 3

Entry # 4

(Checks/Cash)

(On-Line Only)

Total to Date

Life Watch Rocks