PA State Event Info PA State Registration PA State Materials Order PA State Divisions PA State Rules

Materials Request- 2009 USBA Pennsylvania State Breaking Championships

Registration is closed

All material orders must be in by 4/2/2009

Online Materials Ordering                    Materials Ordering by mail

Online Materials Request and Purchase: (click here for official rules)

Competitors are required to purchase breaking materials from supply committee as outlined in the official rules.  The Supply Committee cannot guarantee that there will be extra materials the day of the event, therefore those competitors that have prepaid for supplies will be guaranteed their materials first.  Only cash will be accepted for payment the day of the event.

To pre-order your materials securely online please complete the following information in it's entirety and click "submit" at the bottom of the form. You will then be taken to the payment page for secure ordering and payment through "PayPal".

Competitor Info  
Name  
Male/Female  
USBA/WBA Member # if applicable  
Age  
Name of Parent/Guardian if under 18  
Street Address  
   
City  
State  
Country  
Zip Code  
Home Phone  
Cell Phone  
E-mail  
Studio/Team Name  
   
Divisions Entered (from registration) Division Numbers Only
Creative Multi-Directional Wood Breaking  
Creative Open Breaking  
Power Concrete Hand  
Power Concrete Elbow  
Power Concrete Foot  
Speed Board Breaking  
High Jump Board Breaking  
Power Board Hand  
Power Board Elbow  
Power Board Foot  
Non-Spaced Power Board Hand  
Non-Spaced Power Board Elbow  
I hereby submit my materials form to the 2009 PA State Breaking Championships. I agree to save & hold harmless USBA/WBA (USBA llc), Management, Sponsor, Spectrum Health and Racquet Club, their officers, agents, members & employees from any & all liability resulting from injuries to any person or for damages to or loss of property owned or controlled by me. I fully understand and shall adhere to all rules and regulations. I release all photo & video rights that may be used for publicity, promotion and/or media release without any form of compensation.  

Signature (Parent or Guardian if under 18):

Your signature confirms that you have read

and approve of the above release

Your entry at right will act as your signature

 

 
Ordering Materials by Mail:    (click here to download materials request form):

To order your materials by mail please download the material request form above. Complete the materials request completely and return with payment to the address on the form. Be sure to include the $8 "Community Stand Fee", mandatory for all breaking competitors. Completed form and payment must reach us no later than April 2, 2009.