Fees & Registration Form

Copy & Paste this Registration Form into a word document in order to print

Please be sure to complete this entire form and return it with your Registration Fee including the cost of your T-Shirt(s). NOTE:  T-Shirts are optional and not included in the Registration Fee.  The deadline to register is Friday, June 17, 2016.

Name                                                     Adult Registration                            Youth Reg. (Ages 4-17)

                                                               $25.00 Each                                     $10.00 Each

1. _____________________                 ______________                             _____________

2. _____________________                 ______________                             _____________

3. _____________________                 ______________                             _____________

4. _____________________                 ______________                             _____________

5. _____________________                 ______________                             _____________

Total Amount Paid                                                                                          $____________

(Including T-Shirt)

Payment Method - Money Orders

T-Shirt Prices: (All T-Shirt Orders Must Be Received by June 10, 2016)

_____Youth XS (2-4) $8.00                      _____2X - $10.00

_____Youth S (6-8) $8.00                         _____3X - $12.00

_____Youth M (10-12) - $8.00                 _____4X - $13.00

_____Youth L (14-16) - $8.00                  _____5X - $15.00

_____Adult S - $8.00
_____Adult M - $8.00
_____Adult L - $8.00
_____Adult XL - $8.00

Please Make All Money Orders Out to Jennie Bashay. Mail Your Registration Form & Money Order To:

Ms. Jennie Bashay

1220 W. Field St. 

New Iberia, LA  70560