Windshield Repair Olympics
Contestant Registration Form

Complete the form below to register to compete in the 2013 Walt Gorman Memorial Windshield Repair Olympics and attend Auto Glass Week™. Registration deadline is July 8, 2013. There is no on-site registration for this event. Companies may register up to three (3) contestants. All others will be placed on a waiting list. Registrations are processed on a first-come, first-served basis. Space is limited so register early.

You will not be required to provide your credit card information until you are transferred to our secure online payment site.
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Includes admission to all seminars, workshops, social events, one ticket to the Gala Awards Reception and Ceremony, and access to Auto Glass Week Exhibition/Extravaganza where the competition will be held. Contestants may register guests to attend the competition at a fee of $149 per person. Each guest must accompany a competing technician and may register online or on-site.

Company/Payment Information:
Company: Email:    
Address1: Address2:    
City: State/Province : Zip/Postal:
Country: Phone: Fax:
NAME ON CREDIT CARD: First Name: Last Name:

Enter contestant names as they should appear on their badges.

Contestant #1 (REQUIRED)
Full Name: Company:
Registration Type:

Contestant/Registrant #2 (OPTIONAL)
Full Name: Company:
Registration Type:

Contestant/Registrant #3 (OPTIONAL)
Full Name: Company:
Registration Type:

Cancellations & Refunds:

All requests for cancellation and/or refunds must be received in writing by July 19, 2013, and are subject to a $50 administration fee.
No refunds will be given after this date.

Questions or Comments:

Please contact Auto Glass Week c/o AGRR™ magazine, P.O. Box 569, Garrisonville, VA 22463 or call us at 540/720-5584, or fax 540/720-5687 or email: info@autoglassweek.com.