* 1. Athlete Information

* 2. Hotel Name

* 3. Name Hotel Registration Is Made Under

* 4. Shirt Size (Registration must be received by June 26th)

* 5. Your Weight - Expected on July 17th

* 6. Date of Birth (Month/Day/Year)

* 7. Number of Bouts Over Lifetime

* 8. 2013 USA Boxing Registration Number

* 9. Local Boxing Club Name/Affiliation

* 10. Coach's Name

* 11. Coach's Phone Number (Accessible At The Event)

* 12. Payment Type

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