Team Name (Country to Represent):                              

How would you rate your team?                           

Team Captain:                                                      

Email Address:                                                     

Phone Number:                                                    

Street Address:                                                    

City:                                                                     

Province:                           Postal Code:                

 

Make Cheques Payable to PERPETUAL MOTION 

Entry Fee: $150/team (includes H.S.T.)

or $20 for individuals

 

Send Registration to: PERPETUAL MOTION

223 Waterloo Ave., Guelph, Ontario, N1H 3J4  

(519) 222-0095  

Registration Deadline - September 17th, 2010