Rusted Guns Showdown Payment 2007

Rusted Guns Showdown Payment Form
Open to Former Pros, Legends & Icons, Ages 30 & Over
Saturday, November 3, 2007

4PM
$25 Entry Fee
1st Place - Trophy & $100 Cash!

YES! I would like to compete in The Rusted Guns Showdown!

First Name:
Last Name:
Age:
City / State:
Email:
Phone Number:
Tell us a little about yourself: (include previous sponsors, video appearances and contests. Also, what you are doing now.)
PAYMENT INFORMATION REGISTRATION WILL NOT BE PROCESSED UNTIL PAYMENT IS RECEIVED
Amount Due:
Discounts:	15% Before October 15 10% October 16-22 Add 8.25% Sales Tax
Total Due:	(Eisenbergs will re-calculate and if amount is incorrect, Eisenbergs will charge you the correct amount with all applicable discounts and taxes.)
Payment Method:
Card Number:
Expiration Date:
Name on Card:
Billing Address:
Billing City/State/Zip:
IMPORTANT: REFUND POLICY:	Helmets and Waivers (if not already on file) are required. Helmets are available for rent or purchase in our pro shop. No refunds or credits for any reason including but not limited to injuries.
INITIALS:	By initialing above, you accept the terms of registration, including the Refund Policy, Waiver and Helmet Requirements. Registration will not be accepted without your initials.