Please print this form... 2007/2008 Midwest Conference Dues Form (ALPINE)
School ____________________________________________________________________________
Coach/Advisor__________________________Phone________________E-mail___________________
Contact #1 __________________________Phone__________________E-mail___________________
Contact #2 __________________________Phone__________________E-mail___________________
Permanent Campus Address ____________________________________________________________
City __________________________________ State ______________________ ZIP ______________
Division (circle one): CHICAGO OHIO MICHIGAN LAKE SUPERIOR
Please complete BOTH FORMS completely and accurately and return with proper fees to the address below. This form is for the conference dues and are not part of the National fee structure!!! The money from this registration forms is used for the actual operation of the races and associated fees and costs. This fee also includes the secondary insurance policy which is required by the race hills. All registered racers MUST pay the fee and be listed to be included on the insurance policy.
The 2007/2008 structure for Midwest Conference fees is as follows:
______ # of racers (First 20 racers) X $60 $_______________
______ # of racers (Additional racers) X $50 $_______________
AMOUNT ENCLOSED: $_______________
Return this form along with your fees by November 20th, 2007 to:
Midwest Collegiate Ski Association
2110 Troy Lane
Plymouth, MN 55447
NOTE: If you HAVE NOT COMPLETED YOUR USCSA NATIONAL REGISTRATION You will not be allowed to race. Contact the National office by visiting: http://www.uscsa.com YOU MUST HAVE YOUR NATIONAL DUES IN TO RACE!
RACER ROSTER School Name _______________________
All members must be LISTED AND PAID!
NUMBER RACERS NAME (Please print legibly) PAID
1
___________________________________________
___________
2
___________________________________________
___________
3
___________________________________________
___________
4
___________________________________________
___________
5
___________________________________________
___________
6
___________________________________________
___________
7
___________________________________________
___________
8
___________________________________________
___________
9
___________________________________________
___________
10
___________________________________________
___________
11
___________________________________________
___________
12
___________________________________________
___________
13
___________________________________________
___________
14
___________________________________________
___________
15
___________________________________________
___________
16
___________________________________________
___________
17
___________________________________________
___________
18
___________________________________________
___________
19
___________________________________________
___________
20
___________________________________________
___________
21
___________________________________________
___________
22
___________________________________________
___________
23
___________________________________________
___________
24
___________________________________________
___________
25
___________________________________________
___________
26
___________________________________________
___________
27
___________________________________________
___________
28
___________________________________________
___________
29
___________________________________________
___________
30
___________________________________________
___________
USE ADDITIONAL PAPER IF NECESSARY