Entry Form
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Heading
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
My Products. (*NGA Membership Card must be purchased through Nationalgym.com $100 Annual Membership)
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Amateur Entry Fee
$70.00
$
70.00
Polygraph Fee
$55.00
$
55.00
Amateur Cross-Over Fee (Entering a 2nd class)
$40.00
$
40.00
(Entering a 2nd Class)
Amateur Cross-Over Fee 3 (entering a 3rd class)
$80.00
$
80.00
(Entering a 3rd class)
Amateur Cross-Over Fee 4 (Entering a 4th class)
$120.00
$
120.00
(Entering a 4th Class)
Pro Entry Fee
$200.00
$
200.00
Pro Cross-Over Fee
$150.00
$
150.00
Total
$0.00
$
0.00
Credit Card
Submit
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