School/Team ____________________________________________
Division Circle one: Collegiate - Open
Contact Person (indicate coach, captain, advisor) _____________________________________________________
Home Phone (_____)__________________ Other Phone (work, cell, etc.) (______)____________________
Fax (______)____________________ eMail address _____________________________________
Home Address ______________________________________________________________________
City ___________________________________________ Province __________________________
Postal Code _______________________
Registration Fee is $15.00 per Athlete and Coach.
Number of Athletes Competing:___________ x $15.00 = ___________
Number of Coaches/Trainers __________ x $15.00 = ___________
Total Entry Fee: ___________
*Teams may have any number of athletes on the floor (ie you are not limited to 20)*
*Please photocopy this form and keep for your records.
Entry Fee Payment cheques are Payable to PCA or Power Cheerleading Athletics. We do not accept P.O.'s or Credit Cards
Mail Entry fee and form to
3 Horn St. London, Ontario. N6C 3K3
FAX: (519) 434-9531 NOTE: Application is not valid until entry fee is received.
Questions: 1-800-567-7221
eMail: PCA@powercheerleading.com