ENTRY FORM

16TH ANNUAL
LOS CUERNOS DE TEJAS
 BIG GAME CONTEST    2011-2012


NAME_________________________________________________SIGN-UP DATE________________

ADDRESS___________________________________________________________________

CITY________________________________________ STATE__________  ZIP___________

 PHONE #: _______________________________  CELL #: ____________________________

E-MAIL: ___________________________________________________________________

 

CATEGORY: (CIRCLE ONE)         MALE    *    FEMALE    *    YOUTH-age______   *   80YRS & UP    *   
                                   

For Scholarship purposes - are you a 2012 High School Graduate?   __________

 

$25.00 SIGN UP FEE

 

CHECK# _____________________  CHARGE TO ACCT: _______________________________________

CREDIT CARD# ______________________________________   EXP _______________

                               CVV#  (LAST 3 DIGITS ON BACK OF CARD)  __________                                                                                                                      

SIGNATURE for CREDIT CARD:  _____________________________________________________

 

 JACKET SIZE:  ADULT (MEN'S) ________ / YOUTH ________

                           
   FAX ENTRY TO:  830-876-5914  ---  PHONE ENTRY TO:  830-876-5354
 OR
    MAIL ENTRY TO:  Los Cuernos De Tejas, HC-1 Box 62, Carrizo Springs, TX  78834
                                                               
   Ceremony will be held on March 26, 2011