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School: ______________________________________________________

Address: _____________________________________________________

Contact Name: ________________________________________________

Contact Phone: ____- ____-______    Contact Fax: ____- ____- ________

Contact E-mail address: ________________________________________

In the event of an emergency and the competition has to be rescheduled please provide me with an emergency contact number.  This number will only be used if the competition has to be rescheduled.

Emergency Contact Number:  ____ - _____ - ________

Number of Teams Registered-1

Number of Individuals Registered-1234

Please return this form by competition deadline date.  

Confirmation packets will be mailed the first of next year.  

Forms can be mailed or faxed to:

Dr. Laquetta K. Cortner

Ohio University

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