FEDERATION: ________________________________________________________

We intend to enter a team to the 13^th World Barefoot Water Skiing Championships. We anticipate our team planning as follows:

____ Male Skiers / ____ Female Skiers / ____ Team Officials

____ Coaches / ____ Managers

We also expect to enter skiers who qualify in the Top 12 Ranking Lists as individual entrants:

JUMP EVENTS

____ Male / ____ Female

TRICK EVENTS

____ Male / ____ Female

SLALOM EVENTS

____ Male / ____ Female

Contact Person for future information (Please type or print legibly):

Name ____________________________________________________________________

Address ____________________________________________________________________

Phone ____________________________________________________________________

Fax ____________________________________________________________________

E-Mail: ____________________________________________________________________