Please write all card names completely and legibly.
Judge Use Only: M S E
Please include the quantity for each card.
Last Initial
Full Name: Date: M M / D D / Y Y Y Y
Main Deck Total
Konami Player ID: Event: 40
Monster Cards Spell Cards Trap Cards
3 Ash Blossom & Joyous Spring 1 Bingo Machine, Go!!! 2 Infinite Impermanence
2 Blue-Eyes Alternative White Dragon 1 Called by the Grave 1 The Ultimate Creature of Destruction
2 Blue-Eyes Jet Dragon 1 Cards of Consonance 1 True Light
3 Blue-Eyes White Dragon 1 Dragon Shrine
2 Dictator of D. 1 Harpie's Feather Duster
2 Nebula Dragon 1 Piercing the Darkness
3 Sage with Eyes of Blue 1 Raigeki
2 The White Stone of Ancients 2 Return of the Dragon Lords
1 The White Stone of Legend 2 The Melody of Awakening Dragon
3 Trade-In
2 Ultimate Fusion
20 <<< Total Monster Cards 16 <<< Total Spell Cards 4 <<< Total Trap Cards
Side Deck Extra Deck For Judge Use Only
1 Azure-Eyes Silver Dragon Deck List Checked?
1 Black Rose Moonlight Dragon Judge Initial Infraction(s):
Description:
1 Blue-Eyes Alternative Ultimate Dragon
1 Blue-Eyes Spirit Dragon
1 Blue-Eyes Twin Burst Dragon Deck Check Rd:
1 Blue-Eyes Tyrant Dragon Judge Initial Infraction(s):
Description:
1 Clear Wing Synchro Dragon
1 Hieratic Sun Dragon Overlord of Heliopolis
1 Linkuriboh Deck Check Rd:
1 Number 107: Galaxy-Eyes Tachyon Dragon Judge Initial Infraction(s):
Description:
1 Number 38: Hope Harbinger Dragon Titanic Galaxy
1 Number 46: Dragluon
1 Number 97: Draglubion
1 Samsara, Dragon of Rebirth
1 Stellar Wind Wolfrayet
0 <<< Total in Side Deck 15 <<< Total in Extra Deck
