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2008 Dust-Off Championships Qualifier 4 - Registration

Posted By: NickFitz | On July 2, 2008 - 10:14pm |

This form will register you for the 2008 Dust-Off® Championships: Qualifier 4 that will be held on July 19-20th, 2008.

Please fill out the form in its entirety, and use ACCURATE information. Names will be checked against a valid photo ID, and incorrect e-mail or contact information may result in the forfeiture of your registration and payments.

Personal Information

This is all of your personal contact information. Please full this out completely and accurately. We will use the information provided to contact you for updates and or errors about your registration.

First Name: *

Last Name: *

E-mail : *

Street Address: *

Example: 11640 Rockville Pike

City, State, Zip: *

Example: Rockville, MD 20852

Team Information

Please enter your team information. There is no join password for a team; just enter your team's name and you will be manually added to the appropriate roster.

Alias / Game Name: *

Team Name: *

IRC Channel: *

Marketing Information

How did you hear about this event?: *

Examples: X3O-Gaming.com, GotFrag.com, Esportsea.com, IRC, NickFitz, X3O Gaming Center, etc.

Do you currently use Dust-Off products? (Dust-Off Keyboard Quiver, Dusters, Monitor Wipes): *