DustyRitter.com - The BlackJack Men's Championship & Winter Cup Challenge

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Meet Entry Instructions for BlackJack:

Full Entry Due December 1st

$125 PER GYMNAST - $50 PER TEAM (3 or more per session).

Option #1

Send your roster with $100 Deposit check to:

Dusty Ritter Gymnastics, LLC
315 Simon Bolivar Drive
Henderson, Nevada 89014

Option #2 Entry Form

1. Fill out the entry form below
2. Click the print and email button and a PDF file will be generated
with your entry form ( Adobe Acrobat required to open PDF file DOWNLOAD)
3. Save or open the file to print.
4. Print the file and send with your deposit check to the address above
5. A backup copy of your entry form will be sent to the email address provided

*Contact:
*Club Name:
*Address:
*City:
*State:
*Zip Code:
*Gym Phone:
*Gym Fax:
*Cell:
*Email:

Coaches Attending:	USAG#	Safety Cert Date:

Athlete’s Name:	Level:	USAG#	Birthdate:















Print the form and please send by mail. (see above for more details) A copy of your registration information will be sent to the email provided above.