Application for Payment by School or Club 2024

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IMPORTANT INFORMATION BEFORE PROCEEDING:

1. Applications will be taken on a first-come, first-serve basis with priority given to hosting school districts.
2. Prepaying for slots will hold those slots for your Pentathletes (Note: No refunds for prepaid slots).
3. The deadline to SUBMIT ALL REGISTRATIONS is March 1.
4. The deadline for PAYMENT to be received is March 10.

Email *

Guidelines:

In order for your Pentathletes to compete, REGISTRATION AND PAYMENT MUST BE COMPLETED. If you PREPAY your slots will be held. To use Register & Pay by School/Group you must have a minimum of 10 Pentathletes.

NOTE: The person overseeing registrations will have access to all registration information.

Select Registration Format *

Coach gives parents a PrePaid Code for Parents to complete the Online NMPAT Registration Form for their own child. (Recommended)

Coach completes ALL Pentathletes Online NMPAT Registrations, collects and sends in Signed Parent Agreement Forms, and pays. NOTE: If you enter your students' information, you MUST ALSO mail in the Signed Parent Agreement Form from every parent to the National Office.

Tournament Center Attending *

Your District *

Your School / Club *

Person Overseeing Applications (First & Last Name) *

Email *

Daytime Phone *

Evening Phone *

Payment and Processing

Payment MUST BE RECEIVED BY March 10. After that the price goes up $25 per Registration.

Would you like to Prepay for Tournament Registrations to hold your slots? *

Yes

Payment for Registration will be made by: *

Check/Money Order payable to Pentathlon Institute - postmarked March 10

VISA/MC

Purchase Order Funds due in Full by March 10.

First & Last Name of Person Overseeing Payment *

Phone *

Email *

How many Pentathletes will you be paying for? (If you don't know exact amount please give an estimate) *

What is the projected date for your group to be finished with the registration process?

YYYY

HELPFUL INFORMATION

If you are not contacted within 2 business day after completing this form please call 254-654-9447 or email mathpentathpatricia@gmail.com.

Rene LeBlanc will be overseeing the Online Registration Link and Code for your group to Register. He can be reached at 512-258-5283 or mathpentath@gmail.com.

Chelsea Bounin will be overseeing Payments for Registrations. She can be reached at 317-356-6284 or mathpentathorders@gmail.com

A copy of your responses will be emailed to the address you provided.

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