Please Complete As Much As Possible. Unknowns can be filled in later.
Main Contact Information [confidential - information not sold or distributed]
Name: / Title and/or Position:e-mail address: / Cell Phone: / Home Phone:
Home address: / Tee Size:
City: / State: / ZIP Code:
School Phone: / Number of expected Campers: / Number of expected Adults:
School address:
City: / State: / ZIP Code:
Attending Campers
Number 01 / Name:Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 02 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 03 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 04 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 05 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 06 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Number 07 / Name:
Home Mailing Address: / City: / State: / Zip:
Cell Phone: / E-mail: / Home Phone:
As of 5/01/2013: (Please circle) 8th - Freshman - Sophomore - Junior - Senior / Tee Shirt Size: (Please circle) XS - S - M - L - XL
Notes & Record of Fees Paid:
Notes & Record of Fees Paid:
Mail or e-mail form to: Kansas Shrine Bowl, 503 Lincoln Avenue, Wamego, KS, 66547. or .
Mail Deposits or full fees to the above mailing address or call 800-530-5524 to charge on a credit card. Copy this form to register more participants. Indicate after the name; any adults and their function such, driver, sponsor, coach, assistant, chaperone, etc.
CALL TOLL FREE ANYTIME [800-530-5524] WITH QUESTION AND/OR COMMENTS!