Tailgate Form
Registration deadline for Soccer events: September 1, 2008
Registration deadline for Football event: September 8, 2008
Adult Information
Last Name:
 First Name:
 Maiden (if applicable):
Address Line 1:
 Address Line 2:
 Name Preferred on Tag
City:
 State / Province:
 Zip / Postal Code:
Country:
 Daytime Phone:
 E-Mail Address:
 
Spouse / Guest
Last Name:
 First Name:
 Maiden (if applicable):
Name Preferred on Tag
    
 
Additional Guests
Last Name:
 First Name:

Nickname:

 Age:
 Gender:
M | F
Last Name:
 First Name:
 Nickname:
 Age:
 Gender:
M | F
Last Name:
 First Name:
 Nickname:
 Age:
 Gender:
M | F
Last Name:
First Name:
Nickname:
Age:
Gender:
M | F

Soccer Clinic
Saturday 9:00 a.m, September 6, 2008
$5 admission (Soccer Clinic)
$5.00
0
$0.00

Soccer Picnic Lunch
Saturday 12:30 p.m, September 6, 2008
$12 for Adults (Picnic Lunch)
$12.00
0
$0.00
$8 for Recent grads (Picnic Lunch)
$8.00
0
$0.00
All Children and Students: Free; Please list the child/student(s) name(s) above in the "Additional Guests" Section.

Football Tailgate Dinner with Principia Fans
Saturday 5:30 p.m, September 13, 2008
$15 for Adults (Tailgate Dinner)
$15.00
0
$0.00
$10 for Recent grads (Tailgate Dinner)
$10.00
0
$0.00
$5 for All Children and Students (Tailgate Dinner)
$5.00
0
$0.00
Subtotal:

$0.00
I wish to contribute $5 or more toward the
Principia Club of San Gabriel Valley
Please do not enter a dollar sign, commas or decimal.
$ .00
Total:
$0.00
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