2011 High-Tech Invite by fdh56iuoui

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									2011 High-Tech Invite                                                                                                                                                       Page: 1
                                                                                                                                                       Printed: 1/14/2011 9:59:14 A M


Coach Sign In Sheet                                                                                                                                        Meet Dir: P.J. Slater
                                                                                                                                                            Sanction #: 35172
Jan 15-16, 2011
C oaches, by prov iding y our name and membership information below y ou are certify ing that y ou are a current USA Gy mnastics Professional member in good standing, w ith current
safety /risk management and background check certification, along w ith the proper discipline lev el to participate in stated sanctioned ev ent.
         (Pr int Clear ly and Legibly)                      Pro #          Safety Exp.         (Pr int Clear ly and Legibly)                           Pro #          Safety Exp.
Initial Coaches Name                  Gym                   Pro Exp.       Back Exp.   Initial Coaches Name              Gym                           Pro Exp.       Back Exp.
                                                            017523         11/30/2011                                                                  354143         1/31/2014
         Mark Fong                    American              12/31/2011 12/31/2012                    Daniel Pincus               Santa Cruz            8/31/2011      12/31/2011
                                                            075638         12/31/2014                                                                  358132         10/31/2013
         Neal Yasami                  American              9/30/2011      10/31/2012                Dan Bright                  Technique             12/31/2011 7/31/2011
                                                            704756         2/29/2012                                                                   086227         11/30/2014
         Mike Fretwell                Auburn                1/31/2012      1/31/2011                 Jed Easterbrook             Technique             11/30/2011 6/30/2012
                                                            407140         10/31/2012                                                                  300243         1/31/2012
         Natalie Otis                 Auburn                11/30/2011 7/31/2012                     Louis Grobbelaar            Technique             1/31/2012      12/31/2012
                                                            048126         1/31/2013                                                                   119139         1/31/2012
         Anton Brady                  Cal Sports            1/31/2012      1/31/2011                 John Lucas                  Technique             2/29/2012      2/29/2012
                                                            328249         10/31/2013                                                                  285314         9/30/2011
         Scott Burns                  Cal Sports                           10/31/2012                Anthony Parodi              Tumbleweeds           10/31/2011 10/31/2012
                                                            317162         1/31/2014                                                                   181657         10/31/2014
         Andrew Pileggi               Cal Sports            1/31/2011      12/31/2012                Shamra Petrosky             Tumbleweeds           10/31/2011 8/31/2012
                                                            415026         1/31/2015                                                                   411942         12/31/2012
         Michael Carder               Extreme               1/31/2012      11/30/2012                Lee Pinkstaff               United                12/31/2011 1/31/2012
                                                            425886         11/30/2013
         Daniel Zmrzel                Extreme               1/31/2012      1/31/2013
                                                            417423         2/28/2014
         Kelan Carrizosa              Flips-N-Flops         11/30/2011 4/30/2012
                                                            418944         9/30/2013
         Plamen Avramov               High Sierra           9/30/2011      9/30/2012
                                                            414691         12/31/2014
         Roger Baldwin                High Sierra           12/31/2011 12/31/2011
                                                            416240         1/31/2011
         Stephanie DeBoor             High Sierra           1/31/2011      1/31/2012
                                                            469293         12/31/2014
         Andrew Miguel                High Sierra           9/30/2011      12/31/2012
                                                            206671         9/30/2013
         Laurie Satmary               High Sierra           9/30/2011      8/31/2012
                                                            055352         12/31/2013
         Rick Blake                   Liberty               1/31/2011      12/31/2011
                                                            421391         9/30/2013
         Drayke Farley                Liberty               9/30/2011      9/30/2011
                                                            415820         2/28/2013
         Peter Jenkinson              Liberty               2/28/2011      1/31/2012
                                                            285325         8/31/2011
         Erik Nuno                    Liberty               1/31/2011      1/31/2011
                                                            045470         12/31/2013
         Rebecca Stevenson            Liberty               11/30/2011 11/30/2011
                                                            235040         1/31/2015
         Kirk Taber                   Merced                1/31/2012      1/31/2013
                                                            194748         11/30/2013
         Dylan Etievant               Miyagi                12/31/2011 6/30/2012
                                                            397016         1/31/2013
         Kory Haymond                 Oroville              1/31/2012      1/31/2013
                                                            269289         3/31/2011
         Steve Ross                   Oroville              3/31/2011      3/31/2012
                 The coaches sign in sheet must be returned along w ith the sanction report form. Please make additional copies of this form if more space is needed.
        Return completed sanction report form to: USA Gy mnastics Member Serv ices Department, 132 E Washington St Ste 700, Indianapolis, IN 46204 F ax: 317-692-5212
                                                                       Email: membership@usa-gy mnastics.org

								
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