Lee Evans Tournament of The Americas
Delegate and Coach Entry Form 2006

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Please list your Official Delegate (1) who will accompany team.  Your Official Delegate will have the responsibility for all official tournament and team business, including Lane Marshall of the Day, seeing that fees are paid, scoresheets and all forms are complete and returned, and making any substitutions on team. (Please fill in all requested information)

Delegate Form

(Delegate) Name: __________________________________________________________

Address: ________________________________________________________________________

City: ___________________________________

State/Province:___________________________

Country: ________________________________

Postal Code: __________________________

Occupation: _____________________________

 

Telephone: (day)___________________________

(evening) _______________________________

Fax: ____________________________________

E-Mail: ________________________________

Coach Form
(for additional coaches, please fill out a separate form for each coach)

(Coach) Name: _______________________________________________

Address: ________________________________________________________________________

City: ___________________________________

State/Province:___________________________

Country: ________________________________

Postal Code: __________________________

Occupation: _____________________________

 

Telephone: (day)___________________________

(evening) _______________________________

Fax: ____________________________________

E-Mail: ________________________________

 

Authorizing Official:

Federation Code __________________

Name ___________________________________

Title: _____________________________

Association Name:____________________________________________________________

Telephone: ______________________________

Fax: ______________________________

E-Mail: _________________________________

 

Signature: _______________________________

Date: ______________________________

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Plantation, Florida 33317 USA


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