Coach/Contact Person: Number of Teams: Names or Colors of Teams: Division:
School: School Address: City: State: Zip Code: School Phone: School Fax:
Home Address: City: State: Zip Code: Home Phone:
Email Address:
Each coach is being asked to prepare 1 event. List a few of the events you would be willing to prepare and supervise. First Choice: Second Choice:
Purchase Order #:
* Please send your check or purchase order in the amount of: $60.00 per team
Payable to Chimacum Middle School.
* Your registration is not final until payment or PO is recieved.
Brett Thomsen Chimacum Middle School PO Box 250 Chimacum, Washington 98325
Additional Comments:
Brett Thomsen Science Department Science Olympiad Director 91 West Valley Rd. PO Box 250 Chimacum Middle School Chimacum, WA 98325 1-360-732-4219 (school) 1-360-732-6859 (fax) 1-360-302-1318 (cell)
