ENTRY FORM
13TH ANNUAL
LOS CUERNOS DE TEJAS
ADDRESS___________________________________________________________________
CITY________________________________________ STATE__________ ZIP___________
PHONE #: _______________________________ CELL #: ____________________________
E-MAIL: ___________________________________________________________________
CATEGORY: (CIRCLE ONE)
MALE * FEMALE * 80YRS & UP * YOUTH-age______
For Scholarship purposes - are you a 2009 High School Graduate? ______________________
$25.00 SIGN UP FEE
All entrants with a B&C Score of 170+ will receive a Los Cuernos jacket
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 28, 2009