The 11th  Anniversary　Wakeboard World Series J-ROUND 2006
　　　   NISSAN X-TRAIL CUP   in Odaiba Boukenou

Riders Registration Form

First Name:                            　   

Last name:                            　　 

Address:                                                           

City:                  　　　　　　           State:               　　　　   

Country:                

Fax :                                        Phone :                   

E-mail :                  　　　　　　　　　　　　　　　

Date of birth :                            　

Board Sponsor :                             

Other Sponsor :                               　　　　　　　　                 

(Date&Signature)

                                   　　　　　　　　　　　　　　　　　　          
Please Registration　Form, send FAX  or  E-mail　
Fax   Number     0081-(47)-393-6607
E-mail Address   info@jwba.net

The deadline of entry is June 23th