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<title>|| NSC1.COM || NATIONAL SPORTS CHALLENGE - REGISTER</title>
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<P><font size=5 color=ff0000><u><i>Registration Information</i></u></font>
<P><font size=2 color=000060>Submit Completed form and then Mail the $25.00 money order (no checks) to:
<P>National Sports Challenge<br>P.O. Box 5095<br>Pittsburgh, PA 15206
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<FORM METHOD=POST ACTION="http://www.nsc1.com/formmail.cgi">
<input type=hidden name="recipient" value="morris@gyrfalcon.cas.pitt.edu">
<input type=hidden name="subject" value="NSC Application">
<input type=hidden name="redirect" value="http://www.nsc1.com/thankyou.html">
<input type=hidden name="required" value="realname,Address1,City,State,Zip Code, Day Phone,Evening Phone,Birthday,Age,email,Password">
<input type=hidden name="sort" value="order:realname,Address1,Address2,City,State,Zip Code,Day Phone, Evening Phone,
Birthday, Age, email,Password">
<b><font size=2 face="Arial">
<P>Full Name: <input type=text name="realname" maxlength=75>
<P>Address Line 1: <input type=text name="Address1" maxlength=70>
<P>Address Line 2: <input type=text name="Address2" maxlength=70>
<P>City: <input type=text name="City" maxlength=50>
<P>State: <select name="State">
<option value="AL">Alabama
<option value="AK">Alaska
<option value="AZ">Arizona
<option value="AR">Arkansas
<option value="CA">California
<option value="CO">Colorado
<option value="CT">Connecticut
<option value="DE">Delaware
<option value="DC">District Of Columbia
<option value="FL">Florida
<option value="GA">Georgia
<option value="HI">Hawaii
<option value="ID">Idaho
<option value="IL">Illinois
<option value="IN">Indiana
<option value="IA">Iowa
<option value="KS">Kansas
<option value="KY">Kentucky
<option value="LA">Louisiana
<option value="ME">Maine
<option value="MD">Maryland
<option value="MA">Massachusetts
<option value="MI">Michigan
<option value="MN">Minnesota
<option value="MS">Mississippi
<option value="MO">Missouri
<option value="MT">Montana
<option value="NE">Nebraska
<option value="NV">Nevada
<option value="NH">New Hampshire
<option value="NJ">New Jersey
<option value="NM">New Mexico
<option value="NY">New York
<option value="NC">North Carolina
<option value="ND">North Dakota
<option value="OH">Ohio
<option value="OK">Oklahoma
<option value="OR">Oregon
<option value="PA">Pennsylvania
<option value="RI">Rhode Island
<option value="SC">South Carolina
<option value="SD">South Dakota
<option value="TN">Tennessee
<option value="TX">Texas
<option value="UT">Utah
<option value="VT">Vermont
<option value="VA">Virginia
<option value="WA">Washington
<option value="WV">West Virginia
<option value="WI">Wisconsin
<option value="WY">Wyoming
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<P>Zip Code: <input type=text name="Zip Code" maxlength=5>
<P>Day Phone: <input type=text name="Day Phone" maxlength=15>
<P>Evening Phone: <input type=text name="Evening Phone" maxlength=15>
<P>Date of Birth: <input type=text name="Birthday" maxlength=10>
<P>Age: <input type=text name="Age" maxlength=3>
<P>Email Address: <input type=text name="email" maxlength=50>
<P><i>Please select a password between 4 and 10 characters long:</i>
<br><input type=password name="Password" maxlength=8>
<P><INPUT TYPE=submit VALUE="Submit Information"> <INPUT TYPE=reset VALUE="Reset Form and Start Over">
</form>
<P><font size=1>In consideration of your acceptance of this entry, I, intending to be legally bound, for myself, hiers, executors and administrators, waive and release National Sports Challenge, its sponsors, and co-sponsors and thier respective representatives successors and assigns form any any and all rights and claims for damages I may have arising out of any injuries and illnesses suffered by me in this event, regardless of how such injury or illness may arise and even if such injury or illness is caused by the negligence of such parties. I attest that I will compete in this event and that I am physically fit to do so. Furthermore, I herby grant full permission to NSC and all aforementiond to use my name and any photographs, videotapes, motion pictures, recordings or any other record of me participating in this event for any purpose without obligation or liability to me.
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<br>�1999 National Sports Championships.
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