Individual Entry Form

1
Competitor Email Address* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
example@example.com
2
You will need the following items to submit your entry. Please make sure you have before you proceed.* This field is required.Please check all to confirm and proceed. *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 *** 5.01 General Qualifications - For Individual and Show Acts competitors that have entered a tournament by the entry deadline the following entry requirements must also be met. * DI and DII National Tournaments entry deadline is July 15th of the current year to be in the rotation for that year. (See Chapters 5 & 6 of the NSSA Policies and Procedures for more info on Nationals tournaments entry)
USA Water Ski Membership Card(s)
3
Tournament Selection* This field is required.Please select which tournament you are entering. *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
D1 Nationals
D2 Nationals
Central Regionals
4
Region* This field is required.Please select which region you are representing. *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 *** (A skier is required to ski more than 50% of their on-water time during the 10 week period of time preceding Nationals in the Region in which they are qualifying for Nationals.)
Wisconsin
Central
Midwest
Southern
Eastern
Western
South Central
5
D1 Nats Discipline/Division* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Swivel Open
Swivel Pairs Open
Doubles Open
Women's Freestyle Jump Open
Men's Freestyle Jump Open
Team Jump
6
D2 Nats Discipline/Division* This field is required.*** Reminder: Nationals Individual entry is $80 ***
Swivel Open
Swivel 360
Swivel 180
Swivel Pairs Open
Swivel Pairs 360
Doubles Open
Doubles Intermediate
Women's Freestyle Jump Intermediate
Women's Freestyle Jump Open
Men's Freestyle Jump Intermediate
Men's Freestyle Jump Open
Team Jump
7
Central Regionals Discipline/Division* This field is required.*** Reminder: Central Regionals Individual entry is $50 ***
Swivel Open
Swivel 360
Swivel 180
Swivel Pairs Open
Swivel Pairs 360
Doubles Open
Doubles Intermediate
Women's Freestyle Jump Intermediate
Women's Freestyle Jump Open
Men's Freestyle Jump Intermediate
Men's Freestyle Jump Open
Team Jump
8
Team Affiliation* This field is required.Please select your team. *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
* No Team Affiliation
* Team Not Listed
Aberdeen Aqua Addicts
Aqua Devils
Aqua Skiers
Aquaducks
Aquanuts
Arch Rivals
Backwater Gamblers
Badgerland
Badwater Ski-Ters
Bayside Skiers
Beaverland Must-Skis
Blue Spring Lake
Carolina Show Ski Team
Catfish Bay
Central Florida Show Ski Team
Central Wisconsin
Chain Skiers
Chain Skimmers
Chippewa Lake
Crivitz Ski Cats
Cypress Gardens
Five Seasons
Gatorland
Grand City
Hartwick Huskys
Holiday SHores
Holland Aqua Riders
Hydroflites
Kwahamots
Lake City Skiers
Lake Lotwana
Lake McQueeny Ski Bees
Lake Mohawk
Lakeland Water Ski Club
Laton Lake
Little Crow
Mad City
Maine Attraction
McQueeney Ski Bees
Min-Aqua-Bats
Oxbow
Pewaukee Lake
Plum Ski-Ters
River City
River Rats
Rock Aqua Jays
Shawano Ski Sharks
Shermalot
Shockwaves
Silver Lake
Ski Broncs
Ski Otters
Ski Sprites
Ski-A-Rees
Southern Wakes United
Spray Masters
Tampa Bay WSST
Tommy Bartlett Show
Twin Bridge
US Water Ski Show Team - NY
Water Bugs
Waterboard Warriors
Waterhawks
Webfooters
Whitmore Lake
Wonder Lake
9
Competitor Name* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
First Name
Last Name
10
Competitor Address* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
11
Competitor Telephone Number* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Area Code
Phone Number
12
Second Competitor Name*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
First Name
Last Name
13
Second Competitor Address*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
14
Second Competitor Phone Number*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Area Code
Phone Number
15
Second Competitor Email*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
example@example.com
16
Team Jump RosterName - USA-WSWS #
Huge
Large
Normal
Small
Ok
Ok
17
USA Water Ski & Wake Sports Membership Number* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
18
Second Competitor USA Water Ski & Wake Sports Membership Number* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
19
Are you a citizen of the USA* This field is required.(Non-citizens may enter swivel-doubles and freestyle but will only be accepted if the slots do not fill and will not place. For Team Jump at least one member of the team must be a USA citizen.) *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
YESNO
20
Will you require a sponsor-supplied Tow- Boat? * This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
YESNO
21
Will you require a tournament Driver? * This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
YESNO
22
If using a Team boat, which team and Driver Name? *** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
23
Copy of Competitor USA-WSWS card* This field is required.*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
24
Copy of Second Competitor USA-WSWS card*** Reminder: Nationals Individual entry is $80, Central Regionals Individual entry is $50 ***
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
25
How will you make payment* This field is required.If choose an online option it will take you to a new page to make payment
Venmo - $50 (Central Regionals)
Check - $50 (Central Regionals)
26
Backwater Gamblers PayPal PaymentYou need to create a PayPal account if you don’t already have one. Then you need to link your bank account or a debit card to it. Then pay with your PayPal account, pay as a friend to avoid the service fee. Sending money with PayPal friends and family only takes a few steps: Login to your PayPal account. Click Send & Request. Under Send money, Enter phone number, email or contact name. When prompted, select Sending to a friend. Enter payment amount, add a note (Central Regionals Entry Fee ($50) for ______) and Submit. Use email backwatergamblers@outlook.com
27
Backwater Gamblers Venmo PaymentPay Backwater Gamblers via Venmo. Be sure to note Central Regionals Entry fee ($50) and for whom. @Backwater-Gamblers
28
Central Regionals Check Option

Backwater Gamblers Check's Payable to Tournament LOC by July 4th (must be postmarked by then)

Payable to:

Backwater Gamblers Water Ski Show Club, Inc

Send to:

Backwater Gamblers Water SKi Show Club, Inc

c/o Kenzie Clawson

1515 State Street

Apt 235

Bettendorf, IA 52722
29
Ski Broncs PayPal Payment - $50 per Entry - no refunds after 6/30/24You need to create a PayPal account if you don’t already have one. Then you need to link your bank account or a debit card to it. Then pay with your PayPal account, pay as a friend to avoid the service fee. Sending money with PayPal friends and family only takes a few steps: Login to your PayPal account. Click Send & Request. Under Send money, Enter phone number, email or contact name. When prompted, select Sending to a friend. Enter payment amount, add a note (Central Regionals Entry Fee for ______) and Submit. Use email or QR code Skibroncs@gmail.com
30
Ski Broncs Check's Payable to Tournament LOC by July 15th (must be postmarked by then)

D1 Nationals

Ski Broncs

PO Box 15478

Loves Park, IL 61132
Should be Empty: