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FORM MUST BE SUBMITTED BY AUGUST 15TH
PLAYER ONE / MAIN CONTACT *
Status *	Non Member $140.00 Member CEP $120.00 Member CEP 79m $100.00
E-mail *
Phone: *
PLAYER TWO
Status	Non Member $140.00 Member CEP $120.00 Member CEP 79m $100.00
Phone
E-mail
PLAYER THREE
Starus	Non Member $140.00 Member CEP $120.00 Member CEP 79m $100.00
E-mail
Phone
PLAYER FOUR
Status	Non Member $140.00 Member CEP $120.00 Member CEP 79m $100.00
E-mail
Phone
Total Registration to be paid *