Registration Form Loews Coronado Bay Resort Surf Dog Competition, Saturday, June 20, 2009

SURF DOG INFORMATION:

Category (please click on the drop down arrow to select one):

Heat One: Surf Dogs 40 lbs & under Heat two: Surf Dogs 41 lbs & over

Dog's Name:

Dog's Breed:

Heat Three: Surf Dogs & Owners

Owner's Name (for Heat Three)

CONTACT INFORMATION:

Phone:

Name:

Email Address:

ATTENDANCE INFORMATION:

# of adults:

# of children:

PAYMENT INFORMATION: $50 each for Heats One & Two.  $55 for Heat Three.  Please RSVP by 5 p.m. on June 19 to avoid late fees.

Loews Coronado Bay Resort accepts payment by MasterCard, Visa or AMEX.  We must collect the following information in order to process your registration.

Choose one below VISA MasterCard AMEX

Card Type:

Card Number:

Complete Billing Address (must be address & zip code that matches card):

Expiration Date:

TOTAL Amount of Charge:

Today's Date:

Please complete the above registration form by clicking on the submit button after filling in the fields.

There is no cost to attend and watch.  Snacks and beverages will be available for purchase at the event (cash only).  All proceeds will benefit Loews Coronado Bay Resort's Good Neighbor Council.

Thank you and good luck!

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