Request Competition Info

Please fill out the form below to receive information on competing at Contest of Champions

Request Info Form

First Name *

Last Name *

Title *

Group/Team Name *

Event *

How Did You Hear About Us? *

Please Give Details *

(ie. Who Referred You, Which Social Media Outlet, Which Magazine, Website, Tradeshow, etc.)

Work Address Line 1 *

Work Address Line 2

Work City *

Work State *

Work Zip Code *

Phone Number *

Email *

Confirm Email *

Confirm Email

Home Address Line 1

Home Address Line 2

Home City

Home State

Home Zip Code

Alt Phone Number

Alt Email

Confirm Alt Email

Confirm Email

# of Travelers *

Arrival Date *

Depart Date *

Additional Comments

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