Text Box: NAME USAG # EXP. DATE SAFETY EXP. MAILING ADDRESS CITY STATE ZIP HOME PHONE WORK FAX E-MAIL GYM AFFILIATION JUDGING RATINGS I GIVE PERMISSION TO PUBLISH THIS INFORMATION SIGNATURE $155 Early Registration by March 20th $140 For 5 or more on one check $195 After March 20th and on site - no discounts Please make checks payable to: Region 8 Congress I WILL OR WILL NOT ATTEND THE BANQUET. (Please Circle One). MAIL REGISTRATION TO: SHEILA RAGLE Region 8 Congress 1870 Eagle Summit Court Lawrenceville, GA 30043-6669 (770) 513-7015 E-Mail: Sheila Ragle sraglesjd@aol.com Marian Dykes mariandykes@aol.com

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REGION 8 CONGRESS

June 3-5, 2004 with USA Championships

NASHVILLE, TN

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