Main Line Slide:

Philadelphia Indoor Rowing Championships

REGISTRATION

January 29,2000

Name____________________________________________

Club_____________________________________________

Street____________________________________________

_________________________________________________

City______________________________________________

State__________ Zip_____________

Date of Birth ______/_______/_______

Sex (circle one) Male Female

Best 2000 time______________________

Weight (circle one)

Heavyweight Lightweight

Event (circle one)

Open Junior Freshman Master Senior Coxswain Children

Veteran A (50-59) Veteran B (60-69) Veteran C (70-79) Veteran D (80-89)

q 8-Man SLIDE

q Mix Slide

Entry Fees:

Make checks payable to: VILLANOVA CREW

q $12 (before 1/15/2000)

q $15 (after 1/15/2000)

q $75 8-Man Slide

Mail Registration AND Waiver to:

Main Line Slide

628 Bridle Road

Glenside, PA 19038

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