2012 Event Application
Your Name
I acknowledge these items:
Event Fees & results must be submitted within 5 business days. A late fee of $50.00 per day shall be charged to the club hosting the match for each day thereafter.
No points will be posted until all fees are received.
I must notify the EXCA Office if my event is cancelled.
Regional Championships MUST BE APPROVED before they are posted to the website.
Submit a separate form for EACH event.
New Event or Change to an existing event: -------Choose One------ New Event Change to an existing event
Event Date:
Event Type: -----Pick from this List------ WPQ State Championship Regional Championship
WPQ & State (single points/single fees)
Regional (triple points/single fees) Click here for an application
Number of Days of the event -----Pick a number----- 1 2 3 4 5
Host Club Name:
Host Member Name:
Address:
City/State/Zip:
Contact Information:
Home Telephone:
Work Telephone:
Cell Phone:
Email:
EXCA Event Sanctioning Fee: $265.00. The EXCA Sanctioning fee is paid one time each year. The fee covers every EXCA Event your Club offers in 2012. Please use a separate Event Application for each event.
Event Name:
Location/Arena:
Event City:
Event State:
EXCA Divisions offered: Please Check
Young Guns (ages 7-11) Youth (ages 12-17) Non-Pro (ages 18 & over) Pro (ages 18 & over) Ride Smart (age 55 & over) Novice
Judges One:
Name:
Telephone:
Judge Two:
I have read the EXCA Rulebook and agree to follow all EXCA rules for this event. I understand the requirements of EXCA and agree to comply fully with EXCA requirements.
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