Heartland Registration Form - 2007

                  

                                                Date: November 16th & 17th, 2007

                                    Location: Grace Evangelical Free Church, Stewartville, MN        

                                    Registration deadline: Nov. 5th, 2007
                                         

                                                       (please fill out completely)

            Team Info                                                                   Coach Info

            Quiz League:____________________                        Coach Name:___________________________

               (i.e. "Rochester YFC", etc…)                                    Address: _______________________________

            Team Name:_____________________                       City/State/Zip: __________________________

            Division (circle one):                                                     Coach Phone #: _________________________

            Varsity                 Little League                                     & E-mail: ________________________

           

            Quizzer Information

            (Include name, grade and denote 1st year quizzers with *)

Quizzer #1: ___________________________   Grade: ____
Quizzer #2: ___________________________   Grade: ____
Quizzer #3: ___________________________   Grade: ____
Quizzer #4: ___________________________   Grade: ____
Quizzer #5: ___________________________   Grade: ____

If your team cannot quiz Friday night, please say so here or contact John Raygor (info below)

_____________________________________________________________________

Registration Deadline: Team registration must be received by November 5th. 

Send registration (with "Lodging Information" sheet) to:

 

John Raygor - 618 Tower Court S.E. Stewartville, MN 55976

Contact Information:

For lodging information, directions, and any questions or comments regarding the event, contact:

 

                        John Raygor     Address: 618 Tower Court S.E. Stewartville, MN 55976
                        Phone: (507) 202-6247; E-mail: raygo014@umn.edu  

                        OR…

                        Paul or Annette Raygor    Address: 618 Tower Court S.E. Stewartville, MN 55976
                       
Phone: (507) 533-6658; E-mail: paraygor@charter.net


World Bible Quiz Association---www.wbqa.org

_____________________________________________________________________________________

 

Yes, I want to attend the 2007 Heartland Open.  I understand that the tournament will not be held responsible for harm, injury, or anything else that may happen during the event to myself or a quizzer.

Coach Signature: __________________________________________    Date: ___________________