2010 State Tournament
Registration

March 19-20, 2010

Calvary Temple-Indy
2901 North Post Road
Indianapolis, IN 46219
 
317-897-7100

Registration Deadline: March 13, 2010

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Please fill in the following information and select the "Submit" button at the bottom of the form.  Then send your check for the registration fee to the address listed below.

Please submit a separate form for each team you wish to register.

Church:
City:
Phone:
Email Address:
Coach:
Assistant Coach:

 

Division:

Searcher       Discover

 

Names and qualifications of two officials representing your team (check all that apply):
	QM  J  TK    SK          [Over 21? Yes  No]
	QM  J  TK    SK          [Over 21? Yes No]

    

	Team Name:
	Names of Quizzers:	Awards Quizzer has received this year:
1.
2.
3.
4.
5.
6.
7.
8.

 

Lunch:  $4.00           Total number of meals needed: 

Registration Fee:    $40 per team  (Payment must be mailed by Saturday, March 13, 2010)

Please send your check (payable to First Assembly of God - Fort Wayne) to:

Pastor Barry Jorris
First Assembly of God
1400 West Washington Center Road
Fort Wayne, IN 46825

Additional Comments

Validation Question

Is fire hot or cold? (Enter "hot")

 

You must press the "Submit" button below to complete your registration.
After Submitting form, print out the confirmation page and send a copy with your payment.

 

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For further information, contact Barry Jorris at:

Phone:  (260) 490-8585         E-mail:  kidsrap@juno.com

[Last updated on Sunday, July 25, 2010]  

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