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2020 Regional Qualifier and Athlete Summit

January 17th - 19th, 2020

Deadline to apply: Saturday, November 30th, 2019. Late applications will not be accepted.

Athlete Application

International phone numbers may be input, using the leading "+" symbol.

*

Coach/Trainers Information

( if none, enter NONE)


Competition Experience


     

(if none, enter NONE)

(if none, enter NONE)

Payment Information

There is a $250 registration fee. Registration includes discounted rate at host hotel, food, transportation to and from the airport, competition registration fee and educational athlete summit registration fee. Payment can be made by credit card through our secure payment site.

Please contact Dr. Kelley Humphries with any questions.

Discount Code

* denotes required information