Payment Reference Invoice Number:

    Participant First Name:

    Participant Last Name:

    Contact Email:

    Contact phone number:

    Date of Birth:

    Select Member Club:

    Select Gender Identity:

    Demonstration Category Age Group (Relevant to Team Selection):

    Championship Category Age Group (Relevant to Team Selection):

    Event #1 (Indicate Full Description as per Regulation Package):

    Event #2 (Indicate Full Description as per Regulation Package):

    Event #3 (Indicate Full Description as per Regulation Package):

    Event #4 (Indicate Full Description as per Regulation Package):