Groupon U.S. Pizza Team Western Culinary and Acrobatic Trials

Groupon U.S. Pizza Team
Western Culinary and Acrobatic Trials
IBIE, Las Vegas
Oct. 8-11, 2016

Name:                                          
Pizzeria:                                       
Address (Street, City, State, Zip):
Phone:                                        
Email:                                          

Brief Bio:                                     

Pizza Description(s):                        

Events

Culinary
Gluten-Free ($150):
Classico ($150):
Gluten-Free & Classico Both ($275):
Athletics/Acrobatics
Freestyle Acrobatics ($75):
Largest Dough Stretch ($75):
Fastest Pie Maker ($75):
Fastest Box Folder ($75):
Triathalon (Any 3 Athletic events, $175):     Freestyle    Largest    Fastest Pie    Box
Quadrathalon (All 4 athletic events, $250):
 

Name on Card:        
Credit Card #:         
Exp. Date (MM/YY):