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 Kashtira Fenrir 3 Kashtiratheosis 1 Kashtira Big Bang
3 Kashtira Unicorn 3 Pressured Planet Wraitsoth 1 Kashtira Preparations
2 Kashtira Riseheart 3 Kashtira Birth 3 Infinite Impermanence
1 Kashtira Ogre 3 Pot of Prosperity
1 Scareclaw Kashtira 1 Terraforming
3 Ash Blossom & Joyous Spring 3 Book of Eclipse
3 Book of Moon
3 Forbidden Lance

13 <<< Total Monster Cards 22 <<< Total Spell Cards 5 <<< Total Trap Cards

Side Deck Extra Deck For Judge Use Only

3 Dimension Shifter 1 Garura, Wings of Resonant Life Deck List Checked?

2 Droll & Lock Bird 2 Divine Arsenal AA-ZEUS - Sky Thunder Judge Initial Infraction(s):
Description:
2 Lava Golem 3 Kashtira Arise-Heart
1 Nibiru, the Primal Being 1 Dark Armed, the Dragon of Annihilation

1 Change of Heart 2 Number 89: Diablosis the Mind Hacker Deck Check Rd:

1 Harpie's Feather Duster 1 Number 11: Big Eye Judge Initial Infraction(s):
Description:
1 Lightning Storm 2 Kashtira Shangri-Ira
3 Dimensional Barrier 1 Donner, Dagger Fur Hire
1 Appointer of the Red Lotus 2 Linguriboh Deck Check Rd:

Judge Initial Infraction(s):

Description:

15 <<< Total in Side Deck 15 <<< Total in Extra Deck