This form is not saved - Print a Copy for Your Records After the form has been filled in

Shasta Classic 2012 Entries
*Loft Name :
*Contact Name:
*Address:
*City/State/Zip:
*Email:
*Phone:
Approximate Shipping Date:
Pigeons:
example: 12345-AU10-ARPU
Perch Fee:
Team:
Single Bird:
Single Bird:
   
Form Total:
$

Reload Image
Code:


We apologize for the image verification

Please fill in the box to the left with the code

you see in the image.

If you cannot read it click the speaker

A * indicates a field is required

This form is not saved - Print a Copy for Your Records After the form has been filled in

Entry Fee $300 per bird due Sept 7, 2012

Send birds to:

Dan Welch
10075 Rocking Horse Ln
Redding, CA 96003

Make checks payable to: Dan Welch