GYMNASTICS

2004 FLIPS INVITATIONAL

Team Registration Form & Roster   January 30- February 2, 2004

*Club:________________________________     *Phone: (     )___________*Fax:(    )____________

Club Short Name:_____________________ *E-mail__________

*Club Address:_______________________     *City:______________ *State:_______ *Zip:__________

*Gym Club Number:_____________ Contact person:________________ Contact Phone:____________

*Coach A: ________________________*Safety Exp. Date: ____________*USAG# ___________*Exp_____

*Coach B: ________________________*Safety Exp. Date: ____________*USAG# ___________*Exp_____

*Coach C: ________________________*Safety Exp. Date: ____________*USAG# ___________*Exp_____

*Coach D: ________________________*Safety Exp. Date: ____________*USAG# ___________*Exp_____

* These fields must be completed

                   Optionals and Compulsories: We will use the top 3 scores

(No Team Fees!)    Please type or print legibly.

Gymnast                             Level                   USAG#                Date             Team      

First/Last Name                                                                        of birth         A/B  

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

     ______________________      _______                __________          ______         ________

                        ___________ Compulsory gymnasts @ $70.00 per gymnast   ________

                        ___________ Optional gymnasts @ $90.00 per gymnast         ________

                                                                                                                  Total: ________

Note: Make Checks payable to Flips Gymnastics Corporation (Flips Corp.).  Deposit and registration form is due Nov. 15, 2003. Total Entry Fee Deadline is Dec. 15, 2003. 

NO REFUNDS after Jan. 16, 2004.  Duplicate this form if necessary.