Team Name:

UCLA Superstars Cancer Bite Me

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

Bomben

Lisa

Member

Not on File

Yes

Yes

PU @ Wrap

??

Yes

Yes

$    210.00

$            210.00

$            210.00

Christy

Terri

Member

Online

Yes

No

L

No

No

$                     -

$                     -

Coe

Pam

Member

Online

Yes

Yes

5/13/2010

2XL

Yes

Yes

$    555.00

$    495.00

$         1,050.00

$         1,050.00

Geist

Rodney

Member

Not on File

Yes

Yes

PU @ Wrap

??

Yes

Yes

$    100.00

$            100.00

$            100.00

Macklin

Rosanna

Captain

Online

Yes

Yes

PU @ Wrap

2XL

Yes

Yes

$    250.00

$            250.00

$            250.00

Peters

Shannon

Member

Online

Yes

Yes

5/13/2010

M

Yes

Yes

$    365.00

$    290.00

$            655.00

$            655.00

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

GENERAL DONATIONS

$                     -

$                     -

Registration Overpay

$                     -

$                     -

Corporate Sponsor

$                     -

$                     -

Day Of - Team Raffles

$                     -

$                     -

Day Of -Booth Sales

$                     -

$                     -

6

5

5

5

$    920.00

$    210.00

$    250.00

$    885.00

Total # of bands

Total # of shirts

Total # of lunch

Total # of dinner

capt meet

Relay

acs office

acs office

Count of team members

6

11-May-10

5/22/2010

5/26/2010

6/4/2010

$         2,265.00

$                     -

$         2,265.00

Entry # 1

Entry # 2

Entry # 3

Entry # 4

(Checks/Cash)

(On-Line Only)

Total to Date

UCLA Superstars Cancer Bite Me