Team Name:

Hardcore Fitness Bootcamp

Team Fee Paid:

Qualify for

LAST NAME

FIRST NAME

Method of Indivdual Registration

Minor Under 18yrs

Wrist band

Event T-shirt ($100)

Shirt Size

Free Lunch ($100)

Free Dinner ($100)

CHECKS/CASH

ON-LINE

GRAND TOTAL

Blaha

Jodi

Member

Online

Yes

No

XL

$                     -

$                     -

$                     -

Blaha

Martin

Member

Online

Yes

No

XL

$                     -

$                     -

$                     -

Garrett

Chad

Member

Online

Yes

No

XXL

No

No

$                     -

$                     -

$                     -

Garrett

Stephanie

Member

Online

Yes

No

M

No

No

$                     -

$              50.00

$              50.00

King

Tracey

Member

Online

Yes

No

2XL

$                     -

$                     -

$                     -

Lear

Kahlia

Member

Online

Yes

No

S

No

No

$                     -

$                     -

$                     -

Lopez

Nadia

Member

Online

Yes

No

S

No

No

$                     -

$                     -

$                     -

Nolan

Larry

Captain

Online

Yes

No

XL

No

No

$                     -

$                     -

$                     -

Pourshahidi

PJ

Member

Online

Yes

No

XL

$                     -

$                     -

$                     -

Serrano

Felice

Member

Online

Yes

No

L

$                     -

$              20.00

$              20.00

Torres

Sharese

Member

Online

Yes

No

M

$                     -

$                     -

$                     -

Zimmerman

Cathleen

Member

Online

Yes

No

L

$                     -

$                     -

$                     -

Zimmerman

Randy

Member

Online

Yes

No

XL

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

$                     -

GENERAL DONATIONS

$                     -

$            370.00

$            370.00

Registration Overpay

$                     -

$                     -

Corporate Sponsor

$                     -

$                     -

Day Of - Team Raffles

$                     -

$                     -

Day Of -Booth Sales

$                     -

$                     -

13

0

0

0

$             -

$             -

Count of team members

13

Total # of bands

Total # of shirts

Total # of lunch

Total # of dinner

$                     -

$            440.00

$            440.00

Entry # 1

Entry # 2

(Checks/Cash)

(On-Line Only)

Total to Date

Hardcore Fitness Bootcamp