2005 U.S. Collegiate Championships Order and Reservation Form Check the LOC website for more details - www.hawaiifsc.org Name: _______________________________________ Address: _______________________________________ City/State/Zip _______________________________________ Email: _________________________ Ph: ________________ Mail Forms to: Make check payable to: Hawaii FSC 1165 Kukila Street Hawaii FSC Honolulu HI, 96818 ------------------------------------------------------------------------ Payment summary (Please fill in from each section) Practice Ice $______ Rink Shuttle $______ Total payment included Welcome Dinner $______ Program Ad $______ $ ________ Polynesian Luau $______ Competition T-shirt $______ ------------------------------------------------------------------------ Unofficial Practice Ice # (1 or 2) of 45 min sessions, Tuesday 8/9 _____ @ $10 $______ # (1 only) 45 min session, Wednesday 8/10 _____ @ $10 $______ Total $______ ------------------------------------------------------------------------ Welcome Dinner Tuesday, August 9, 2005 5:00 - 8:00 PM Ice Palace Mezzanine. # competitors/designated coach/official attending ___ @ $0.00 $_0.00_ # additional guests attending ___ @ $8.00 $______ Total $______ Please list competitors/designated coach/official attending _________________________ ____________________ __________________________ Note: The starting order draw party will be held during the dinner. -------------------------------------------------------------------------- Polynesian Luau Saturday, August 13, 2005 5:00 - 8:00 PM Paradise Cove. (See www.paradisecove.com for luau details) # of persons attending (Adult): _____ @ $35.00 =$ ________ # of persons attending (13-18): _____ @ $31.00 =$ ________ # of persons attending (3-12): _____ @ $28.00 = $________ # of persons using bus transport _____ @ $10.40 = $________ from and to Waikiki: Total $________ For Luau Bus Transportation only: (We strongly recommend using the Luau bus transportation unless you are familiar with the destination.) Your hotel _____________________________ (Please enter now, if known) Bus pick up point and pick up time will be provided to you at the competition. ---------------------------------------------------------------------------- Ground Transportation (shuttle between rink and Ocean Resort Hotel Waikiki) Do you plan to rent a car? Yes __ No __ # competitors/coaches/officials using LOC bus ___ @ $ 0.00 $_0.00_ # additional guests using LOC bus (4 days) ___ @ $20.00 $______ Total $______ Please list persons using bus (show category for each: S=skater, C=designated coach, G=guest, O=official) __________________________ _____________________ ___________________________ __________________________ _____________________ ___________________________ ------------------------------------------------------------------------------ Ad in Competition Program Place a "Good Luck" ad - 30 words - about 2 or 3 lines $10.00 $ ______ Message: ______________________________________________________ _______________________________________________________________ Or following sizes for camera-ready ads: Business card size - $20 1/4 page - $40 1/2 page - $60 Full page - $100 $ ______ (Please include the camera-ready ad; do not staple or paperclip.) -------------------------------------------------------------------------------- Competition T-Shirts Check out the competition T-shirt design on the LOC website. www.hawaiifsc.org T-shirts come in short-sleeve, long-sleeve, and spaghetti-strap tank options. Only pre-ordered T-shirts will be printed. They will be delivered on Tuesday, August 9 at the rink. NAVY IS THE ONLY COLOR OFFERED FOR ALL SHIRT STYLES. Short Sleeve With Crew Neck - Adult Sizes SIZE: AS____ AM____ AL____ XL____ @$17.00 XXL ____ @$18.00 XXXL_____@$19.00 Total $______ Long Sleeve with Crew Neck - Adult Sizes SIZE: AS___ AM___ AL___ XL___ @$20.00 XXL___ @$21. Total $______ Spaghetti-Strap Tank - Adult Sizes SIZE: AS___ AM___ AL___ XL___ @$17.00 Total $______ T-Shirt Sum Total $______