Zone: Imagination!
Regional Celebration
Registration Form

This is a new 2008 - 09 registration  
This is an update to a previously submitted 2008 - 09 registration
(for updates: you need complete only fields in blue and furnish updated information)

Please provide the following Membership information:

Membership Name:
Membership Number:
School Name:
School Address:
City/Town: State: Zip:
Team Name:

Please provide the following Team Manager information:

Name:
Street Address:
City/Town: State: Zip:
Day Phone: Evening Phone:
E-mail

Please provide the following Team Co-Manager information (if applicable):

Name:
Street Address:
City/Town: State: Zip:
Day Phone: Evening Phone:
E-mail

Please provide the following Team Member information:

Name

Grade

Challenge:         Level: 

Your Registration Fee includes providing one trained appraiser and one volunteer for your Regional Celebration.  Should your team go on to State Celebration, your appraiser and volunteer need to go as well. 

Please provide the following Appraiser information:

Name:
Street Address:
City/Town: State: Zip:
Day Phone: Evening Phone:
E-mail

Please provide the following Volunteer information:

Name:
Street Address:
City/Town: State: Zip:
Day Phone: Evening Phone:
E-mail

Choose one of the following payment options: Check   PO   Check/PO Number:  

Comments:  Please list any disabilities or scheduling conflicts that exist for team members, appraisers and/or volunteers.


 Next:    (1)  Print this form
              (2)  Send form with payment to:
                    CreateME
                    PO Box 816
                    Holden, ME  04429 
            Key your initials here if you have printed this form and are now ready to submit it?                                                                             

 


Revised: 10/21/08