ISI # CALIFORNIA STATE GAME
SAN DIEGO ICE ARENA ISI OPEN CHAMPIONSHIPS MAY 24th, 2015 ISI # 1-2475-2014 SYNCHRONIZED SKATING AND PRODUCTION # ENTRY FORM Name of Team _______________________________ Rink __________________ Phone # ____________ # Of Skaters ___________ @ $20.00 each = $_______________ (Make check payable to San Diego Ice Arena) Mail to: San Diego Ice Arena, 11048 Ice Skate Place, San Diego Ca. 92126 Att: Kerrie Armijo PLEASE CHECK THE APPRORIATE BOX: Production # ( ) Synchronized Formation ( ) Synchronized Skating ( ) Advanced Formation Team ( ) Open Skating Team ( ) AGE CATEGORY FOR SYNCHRONIZED SKATING TEAMS Tot Team (maj. 6ys. and under) ( ) Youth Team (maj. 9-11 yrs) ( ) Teen Team (maj. 14-19 yrs) ( ) Collegiate Team (maj. 18-25yrs) ( ) Jr. Youth Team (maj. 8 ys. and under) ( ) Sr. Youth Team (maj. 12-14 yrs) ( ) Adult Team (maj. 20 yrs. and over) ( ) Synchronized Skaters ---- Please list your age as of 7/01/14 Are you an active USFS member who has competed at or above the Novice level (individual or synchronized) at any USFS National Championship with the last 2 years? Yes ____ No ____ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. NAME _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ AGE _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ ISI# ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. NAME _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ AGE _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ ISI# ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ Coach’s Signature ____________________ Coach’s Email ____________________ Entry Deadline *** April 25th, 2015
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