Winter Energizer will be held at Valley Catholic HS February 19-21, 2010. Please be sure you can commit to that date before you apply! .

Name:

School or Organization:

Address:

City:

ZIP:

Cell Number:

E-mail:

I am applying for: S.C. Position J.C. Position

I can't be there all weekend, but would like to present a workshop (on Saturday, February 20th)

Here are some topics I'm interested in presenting a workshop on:

1.

2.

3.

Here are some activies for the Energizer I'd like to help with:

1.

2.

3.

I do want a Trailblazer ticket for the game February 21st (Compliments of OASC for giving your time.)

I am willing to commit to that date!

Signature:

Date:

Please enter the Security Code you see above
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