2006 LONE STAR KICKING CHALLENGE
  
 


LAST NAME: _________________________________________

FIRST NAME: ________________________________________

EVENT(s): (Please Circle)

Punter   |   Kickoff   |   Field goal   |   Snapper

HIGH SCHOOL: _____________________________________________

HT: _____ WT: _____ JERSEY #: _______

BIRTHDATE: _____/______/ 19______

2006-2007 CLASS (please circle):       SR   |   JR   |   SO   |   FR

HOME ADDRESS:____________________________________________

CITY: ________________________________ ZIP: __________________

HOME PHONE: (_______)_____________________

EMAIL: _____________________________________

PARENT'S FAX: ___________________________________________

-- Cost: $30 per player/$50 if two or more events --

Randy Rodgers' Fax: (512) 327-3774

Mail to:
Rodgers Recruiting
6201 Olympic Overlook
Austin, TX 78746
For more info, call Randy Rodgers at (512) 327-1537 or email: randyrodgers@earthlink.net

TO PRINT THIS FORM: JUST CLICK ON YOUR PRINT BUTTON -- OR HOLD DOWN THE CONTROL KEY AND TYPE "P"
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For office use only:       Method of payment: Cash_____________ Check: _____________

Date Received: _______________________________________