Contest BIGGEST LOSER PCEP Team Sign Up Sheet Sign Up: TODAY through May 12 : online at www.ﬁtnessandsportsperformance.com OR print out the Team Sign-Up sheet and return it with payment to the Salem Athletic Department Mailbox. Cost: $129 per person - Get $30 back by referring someone who starts another team. Payment Methods: cash, check, or credit card. * If you choose to pay by credit card, I will e-mail you an invoice. Individual (We’ll add you to a team!) Name: _________________________ Date of Birth: ____________________ Phone #: _______________________ E-mail Address: ___________________ Payment Method: _________________ Who referred you?__________________ Team Name: _____________________ 1.Captain: _________________________ Date of Birth: ___________________ Phone #: _______________________ E-mail Address: ____________________ Payment Method: _________________ Who referred you?___________________ 2. Name: _________________________ Date of Birth: ___________________ Phone #: _______________________ E-mail Address: ____________________ Payment Method: ___________________ 3. Name: _________________________ Date of Birth: ___________________ Phone #: _______________________ E-mail Address: ____________________ Payment Method: _________________ 4. Name: _________________________ Date of Birth: ___________________ Phone #: _______________________ E-mail Address: ____________________ Payment Method: _________________ 5. Name: _________________________ Date of Birth: ___________________ Phone #: _______________________ E-mail Address: ____________________ Payment Method: _________________ Questions or Comments? Contact Tiffany Grubaugh 949.303.3479 [email protected]

BL Sign Up · Title: BL Sign Up Author: Kelly Grubaugh Created Date: 4/29/2011 1:52:08 PM

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ContestBIGGEST LOSERPCEP

Team Sign Up SheetSign Up: TODAY through May 12: online at www.fitnessandsportsperformance.com OR print out the Team Sign-Up sheet and return it with payment to the Salem Athletic Department Mailbox.

Cost: $129 per person - Get $30 back by referring someone who starts another team.Payment Methods: cash, check, or credit card.

* If you choose to pay by credit card, I will e-mail you an invoice.

Individual (We’ll add you to a team!)

Name: _________________________ Date of Birth: ____________________Phone #: _______________________ E-mail Address: ___________________ Payment Method: _________________ Who referred you?__________________

Team Name: _____________________

1.Captain: _________________________ Date of Birth: ___________________Phone #: _______________________ E-mail Address: ____________________ Payment Method: _________________ Who referred you?___________________

2. Name: _________________________ Date of Birth: ___________________Phone #: _______________________ E-mail Address: ____________________

Payment Method: ___________________

3. Name: _________________________ Date of Birth: ___________________Phone #: _______________________ E-mail Address: ____________________

Payment Method: _________________

4. Name: _________________________ Date of Birth: ___________________Phone #: _______________________ E-mail Address: ____________________

Payment Method: _________________

5. Name: _________________________ Date of Birth: ___________________Phone #: _______________________ E-mail Address: ____________________

Payment Method: _________________

Questions or Comments? Contact Tiffany Grubaugh 949.303.3479 [email protected]

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