Team Gostar Match BPSA 10 8 & 9/12/2007

1. Team Gostar Match BPSA 10 8& 9/12/2007 Team Gostar Match BPSA 10 8& 9/12/2007 Squad Registration Form Individual Registration Form Name :……………………………………………….. Adress :……………………………………………… Club :………………………………………………… Club :………………………………………………… Name :……………………………………………….. Adress :……………………………………………… City :……………….Code :………….Country :………. Phone:………………………Fax :…………………….. . City :……………….Code :………….Country :………. Phone:………………………Fax :…………………….. . Name Club Division Factor DIVISION Caliber Class 1 2 Open Standard Modified Production revolver Lady Senior S.S Major Minor 3 4 5 6 If 2nd choise not available : 7 1st choice : 2nd choise : Reimbourse 8 Sat AM Sat AM Phone ore fax for another appointement Sat PM Sat PM 9 Sun AM Sun AM 10 Sun PM Sun PM Squadding If 2nd choise not available : I want to be squadded with……………………………………… Reginal director approval………………..Shooter signature……………. 1st choice : 2nd choise : Reimbourse Sat AM Sat AM Phone ore fax for another appointement Sat PM Sat PM One shooter=one registration form=one check Sun AM Sun AM Sun PM Sun PM Info and mail form/ check to SchampheleerDirkHoogstraat 19 Account 755-4249708-94 9260 Schellebelle Squad registration = same time and day = one check Tel : 09/368.08.86 Fax : 09/366.31.49 GSM:0475/85.85.33 E-mail : bpsa@gostars.be