420 PRO-AM TOURNAMENT REGISTRATION FORM
                                                              February 3-5, 2012
          Creekwood Archery                       451 Lawrence Road                       Brockport, NY 14420
                585-392-2030                      Fax: 585-392-9762 (call first)             www.creekwoodarchery.com
PARTICIPANT INFO: (mail or fax a separate completed registration form for each archer)

       _______________________________                        ________________________________________________               
          First Name                                                                            Last Name

          _______________________________                        ________________________________________________                                 
          Phone                                                                                     E-mail

          __________________________________________________________________________________________
          Street Address                                                                     Town                                                State                            Zip Code

          _________________________________________________________
           Your 420 ambassador (see Tournament Information for details)

ADULT DIVISIONS:           
        ☐  Male                   ☐  Female  
           ☐  Championship Division (entry fee $150.00, Payout 75%), no membership or affiliation required
           ☐  Amateur (entry fee $30.00, Payout 40%), no membership or affiliation required

CHAMPIONSHIP DIVISION CLASSIFICATIONS:
           ☐  Male Freestyle (Guarantee $750 with 5 or more in class)  ☐  Female Freestyle (Guarantee $500 with 3 or more in class)
           ☐  Male Freestyle Limited (Guarantee $112.50)                          ☐  Female Freestyle Limited (Guarantee $112.50)

ADULT CLASSIFICATIONS:               
        ☐  Freestyle                                                                             ☐  Freestyle Limited                              
           ☐  Bowhunter Freestyle                                                       ☐  Bowhunter Freestyle Limited
           ☐  Senior (55 & over) Freestyle                                          ☐  Senior (55 & over) Freestyle Limited
           ☐  Senior (55 & Over) Bowhunter Freestyle                    ☐  Senior (55 & Over) Bowhunter Freestyle Limited
           ☐  Recurve/Traditional (male and female combined)

 YOUTH CLASSIFICATIONS
           ☐  Youth (14 & under, boys and girls combined) (entry fee $20.00, Payout medals)
           ☐  Freestyle & Freestyle Limited (combined)                      
           ☐  Bowhunter Freestyle & Bowhunter Freestyle Limited (combined) 

SHOOTING LINE PREFERENCE  (indicate 1st & 2nd choice)
           Friday, February 3               practice 4-8pm   $5 practice fee
           Saturday, February 4         ☐  8 am              ☐ 11 am              ☐  2 pm (if other lines are full)
           Sunday, February 5            ☐  8 am              ☐ 11 am

PAYMENT METHOD:       ☐ enclosed check (make checks out to Creekwood Archery)
                                      ☐ enclosed money order (make money orders out to Creekwood Archery)
                                      ☐ credit card (please call Creekwood for processing)
 Late fees assessed after January 25, 2012: Championship Division $20.00, Amateur Division $10.00, Youth Division $10.00
 Walk-ins will be welcomed if space is available  •  75% refund of registration fees if notice is received by January 25, 2012
 No refunds for any cancellations after January 25, 2012, or to any no-shows  •  In the event the Tournament is canceled there will be a 100% refund
 If there is no competition within a class, classes will be combined