Mid Atlantic Disc Dogs



Check# ______ Amount________

Cash Amount________

Hyperflite Skyhoundz DiscDogathon World Qualifier& Virginia State Championship

Saturday Pot Luck Dinner Prepared by Stanaways & Friends:

Cost $10 /person over 10 yrs. Side dish not required but you can bring one if

you want to show off one of you favorite family recipes. Great food and fun times!

|Handler Name: |      |

|Address: |      |

|City: |      |State: |      |Zip Code: |      |

|Phone: |      |Email: |      |

|Are you a MAD Dog Member? (Check one) | |Yes | |No |Club Affiliation: |      |

| |

|Dog # |Dog |Breed |D/D |S/C |D/D & |D/D |S/C |

| |Name | |Sat |Sun |S/C |Only |Only |

| | | | |Grand Total |      |

|# |DiscDogathon |MAD Dogs Divisions | |State Championship |

| |Event | | |(one event per dog) |

| | |AA Advanced |A |

| | | |Intermediate |

|Competitor | |Signature (under 18) | |

| |Date | |Date |

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