Region III Future Star Testing Entry Form

     Team Information
Club Name:       Club USAG#:
Club Address:
City:                State: Zip:
Phone:            Contact Email:
Name of Coaches Pro # Safety
Certified?		 Exp. Date
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Athlete Name USAG # Age Group Birth Date
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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 form was prepared and filled out by: