LAW ENFORCEMENT AGENCY:

______________________________________________________________________________

TEAM CAPTAIN/CONTACT PERSON:

______________________________________________________________________________

ADDRESS:

______________________________________________________________________________

______________________________________________________________________________

TELEPHONE: (____) _____________________ FAX: (____) _________________________

E-mail: ____________________________________________

$100.00 REGISTRATION FEE

____ PAYMENT ENCLOSED (Required to register)

NOTE: DUE TO GROWING INTEREST IN THE "BATTLE OF THE BADGES"

WE RECOMMEND EARLY REGISTRATION. PAYMENT MUST

ACCOMPANY REGISTRATION. TEAMS ACCEPTED UNTIL

AUGUST 11, 2000 OR UNTIL ALL TEAM SLOTS ARE FILLED.

Send completed Registration Form with Team Registration Fee to:

Fraternal Order of Police – Central Missouri Lodge #19

508 Babe Ruth Drive, Jefferson City, Missouri 65109

FAX: 573/659-7344

For questions or additional information contact:

Randy Dampf, 573/636-6051(leave message)