H	Skating Plus	SC Champ Full Contest - Freestyle Entry Sheet	Entry from:	_________________________	
O	1720 Mesa Verde Ave.	Contest: Dec 13, 2015	Phone:	_________________________	
S	Ventura, CA 93003 	Fax Due: Mon Nov 30   Pmt Due: Dec 7		FAX to: 714-994-2536	
T	(805) 644-2121	Info: www.scal-sk8.org	Or email to	Victora.reinhart@uhc.com	
NAME	Amtr
Card	M/F	Creative Solo	Quartet		Payment	
			#1	#2	#1	#2	#1	#2	1st - $15	Add’l - $15	Total	

												

												

												

												

												

												

												
Mail to: Pam Grenier
3247 London Ln
Oxnard, CA 93036		TOTAL AMOUNT This Page		
				
		TOTAL AMOUNT ENCLOSED		

				

Discipline	Code	Description	
Creative	EA	Elementary A	
	OA	Open A	
	OB	Open B	
	YI	Youth International	
Quartet	QT	Quartets	

Special events are not available in this contest.
For this contest, use the skater’s age as of January 1, 2016.