Midwest Regional - The X Count

Team – 3P Registration

Coach Name

Coach Phone

Coach Email *

Number of Teams Registering *

Team One Name

Team One Discipline

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Precision

Team One Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team One *

First

Last

#1 Athlete Address - Team One

Address Line 1

City

State

Zip Code

#1 Athlete Email - Team One *

Athlete #1 Phone - Team One

Athlete #1 Date of Birth - Team One

Athlete #1 CMP Number - Team One

Team Two Discipline

Sporter
Precision

Team Two Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Two *

First

Last

#1 Athlete Address - Team Two

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Two

Athlete #1 Date of Birth - Team Two

Team Three Discipline

Sporter
Precision

Team Three Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Three *

First

Last

#1 Athlete Address - Team Three

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Three

Athlete #1 Date of Birth - Team Three

Team Four Discipline

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Precision

Team Four Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Four *

First

Last

#1 Athlete Address - Team Four

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Four

Athlete #1 Date of Birth - Team Four

Team Five Discipline

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Precision

Team Five Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Five *

First

Last

#1 Athlete Address - Team Five

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Five

Athlete #1 Date of Birth - Team Five

Team Six Discipline

Sporter
Precision

Team Six Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Six *

First

Last

#1 Athlete Address - Team Six

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Six

Athlete #1 Date of Birth - Team Six

Team Seven Discipline

Sporter
Precision

Team Seven Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Seven *

First

Last

#1 Athlete Address - Team Seven

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Seven

Athlete #1 Date of Birth - Team Seven

Team Eight Discipline

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Precision

Team Eight Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Eight *

First

Last

#1 Athlete Address - Team Eight

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Eight

Athlete #1 Date of Birth - Team Eight

Team Nine Discipline

Sporter
Precision

Team Nine Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Nine *

First

Last

#1 Athlete Address - Team Nine

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Nine

Athlete #1 Date of Birth - Team Nine

Team Ten Discipline

Sporter
Precision

Team Ten Residency

Indiana Team (All Members are Indiana Residents)
National Team (Local Club - Non Indiana Team but all members live within 90 minutes of the registering club)
National Team (Open Club - No restrictions on distance from the club)

#1 Athlete Name - Team Ten *

First

Last

#1 Athlete Address - Team Ten

Address Line 1

City

State

Zip Code

Athlete #1 Phone - Team Ten

Athlete #1 Date of Birth - Team Ten

Athlete #1 CMP Number - Team Two

Athlete #1 CMP Number - Team Three

Athlete #1 CMP Number - Team Four

Athlete #1 CMP Number - Team Five

Athlete #1 CMP Number - Team Six

Athlete #1 CMP Number - Team Seven

Athlete #1 CMP Number - Team Eight

Athlete #1 CMP Number - Team Nine

Athlete #1 CMP Number - Team Ten

#2 Athlete Name - Team One *

First

Last

#2 Athlete Address - Team One

Address Line 1

City

State

Zip Code

#2 Athlete Address - Team Two

Address Line 1

City

State

Zip Code

#2 Athlete Email - Team One *

Athlete #2 Phone - Team One

Athlete #2 Date of Birth - Team One

Athlete #2 CMP Number - Team One

#3 Athlete Name - Team One *

First

Last

#3 Athlete Address - Team One

Address Line 1

City

State

Zip Code

#3 Athlete Email - Team One *

Athlete #3 Phone - Team One

Athlete #3 Date of Birth - Team One

Athlete #3 CMP Number - Team One

#4 Athlete Name - Team One *

First

Last

#4 Athlete Address - Team One

Address Line 1

City

State

Zip Code

#4 Athlete Email - Team One *

Athlete #4 Phone - Team One

Athlete #4 Date of Birth - Team One

Athlete #4 CMP Number - Team One

Athlete #1 Relay Selection - Team One

Athlete #1 Relay Selection - Team Two

Athlete #1 Relay Selection - Team Three

Athlete #1 Relay Selection - Team Four

Athlete #1 Relay Selection - Team Five

Athlete #1 Relay Selection - Team Six

Athlete #1 Relay Selection - Team Seven

Athlete #1 Relay Selection - Team Eight

Athlete #1 Relay Selection - Team Nine

Athlete #1 Relay Selection - Team Ten

Athlete #2 Relay Selection - Team One

Athlete #2 Relay Selection - Team Two

Athlete #2 Relay Selection - Team Three

Athlete #2 Relay Selection - Team Four

Athlete #2 Relay Selection - Team Five

Athlete #2 Relay Selection - Team Six

Athlete #2 Relay Selection - Team Seven

Athlete #2 Relay Selection - Team Eight

Athlete #2 Relay Selection - Team Nine

Athlete #2 Relay Selection - Team Ten

Athlete #3 Relay Selection - Team One

Athlete #3 Relay Selection - Team Two

Athlete #3 Relay Selection - Team Three

Athlete #3 Relay Selection - Team Four

Athlete #3 Relay Selection - Team Five

Athlete #3 Relay Selection - Team Six

Athlete #3 Relay Selection - Team Seven

Athlete #3 Relay Selection - Team Eight

Athlete #3 Relay Selection - Team Nine

Athlete #3 Relay Selection - Team Ten

Athlete #4 Relay Selection - Team One

Athlete #4 Relay Selection - Team Two

Athlete #4 Relay Selection - Team Three

Athlete #4 Relay Selection - Team Four

Athlete #4 Relay Selection - Team Five

Athlete #4 Relay Selection - Team Six

Athlete #4 Relay Selection - Team Seven

Athlete #4 Relay Selection - Team Eight

Athlete #4 Relay Selection - Team Nine

Athlete #4 Relay Selection - Team Ten

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