Last Name                                First Name                DOB        M/F        First Year        Need Plaque
_____________________        _________________        ____        ___        _______        ___________
_____________________        _________________        ____        ___        _______        ___________
_____________________        _________________        ____        ___        _______        ___________
_____________________        _________________        ____        ___        _______        ___________
_____________________        _________________        ____        ___        _______        ___________
_____________________        _________________        ____        ___        _______        ___________

Parent/Guardian Information:
        Last Name:___________________________________________________________________
        First Name:___________________________________________________________________
        Street Address:________________________________________________________________
        Home Phone:_________________________________________________________________
        Work Phone:__________________________________________________________________
        Cell Phone:___________________________________________________________________
        Email Address:________________________________________________________________
In case of emergency please contact:_____________________________________________________
___________________________________________________________________________________

Family Name:___________________________
Email Address:______________________________
Indicate Preference:  Wednesday evening or Friday Mornings.

        Prefer Wednesdays:_______________                        No Preference:___________
        Prefer Fridays:____________________                        Cannot work Fridays:______
Jobs:
Timer:_______________
Snack Stand Coordinator:_______________
Snack Stand:__________________________
Runner(Friday only):____________________
Head Timer:__________________________                                Experienced:_____________
Marshal:_____________________________                        Experienced:_____________
Announcer:___________________________                         Experienced:_____________
Colorado Timing:______________________                                Experienced:_____________
Scorer:______________________________                                Experienced:_____________
Table Coordinator:____________________                                Experienced:_____________
Set-up/Breakdown:____________________                                Experienced:_____________

Officiate:____________________________                                Level & Expiration Date_____