Western Regional Collegiate Cyber Defense Competition

College/ University *

Coach*

Shirt Size *

Coach Phone *

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Coach Email *

Competitor 1*

Shirt Size *

Competitor 2*

Shirt Size *

Competitor 3*

Shirt Size *

Competitor 4

Shirt Size

Competitor 6

Shirt Size

Competitor 5

Shirt Size

Competitor 7

Shirt Size

Competitor 8

Shirt Size

Competitor 9

Shirt Size

Competitor 10

Shirt Size

Competitor 11

Shirt Size

Competitor 12

Shirt Size

Registrant Name

Terms *

Registrant Agrees to Pay $1000 by Dec 31st. (Failure to do so will result in a disqualification)

Registration Fee is $1000 and Covers Food, Lodging and Competition Fee for the Entire Team, however this does NOT cover Travel Expenses.