2009 Future Star Testing

Future Star Testing   Testing Date - October 3, 2009 - Bart Conner Gymnastics
Club Name      Club USAG#:
Team Name(if different):  
Club Address:
City: State: Zip: Region:
Phone: Contact Email:
Name of Coaches Pro # Safety cert. Exp. Date Phone
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Athlete Name USAG # Age as of Sept 1st. Age
Group Entered		 Birth Date
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$60 per gymnast ($10 discount per gymnast if postmarked by September 19th.) 

Mail entry and checks (Made out to Region III) to Gil Elsss, 5000 Fairview Drive, Austin, Tx 78731.

I hereby acknowledge all rules and regulations handed down by USAGymnastics and the State or Regional Director.  I have read and understand all information pertaining to this meet.  This entry form contains all of the proper names, ages and USAG numbers and classes of my gymnasts.

This for was prepared and filled out by;   (signature)___________________________________________