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2003
NORTH AMERICAN TABLE TENNIS CHAMPIONSHIPSBalboa Park Activity Center, San Diego, California, USA, April 4-6, 2003
Waiver
Form (Required of all players)
Please PRINT the following information
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Name |
Street Address |
|
|
City |
Province/State |
Zip Code |
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Phone # |
|
USATT/CTTA Rating |
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Date of Birth (month/day/year) |
Male/Female |
|
Please find
enclosed my check/money order payable to the USATT.
If paying by Visa or Mastercard please complete the following information:
Cardholder__________________________
Card no.__________________ Expiration date_____________________
Signature____________________________
I will abide by
all USATT regulations for tournament play. A signed Release & Waiver of
Liability form is attached.
Signature_______________________________
Parent's signature (if minor)___________________________________
EVENTS
| Event | Check to Enter |
Fee (U.S. Dollars) |
Doubles Partner |
| Women's Singles | $20.00 | ||
| Men's Singles | $20.00 |
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| Women's Doubles | $25.00/pair | ||
| Men's Doubles | $25.00/pair | ||
| Junior Girls Singles | $15.00 | ||
| Junior Boys Singles | $15.00 |
||
| Junior Girls Doubles | $20.00/pair | ||
| Junior Boys Doubles | $20.00/pair | ||
| Cadet Girls Singles | $15.00 | ||
| Cadet Boys Singles | $15.00 | ||
| Cadet Girls Doubles | $20.00/pair | ||
| Cadet Boys Doubles | $20.00/pair |
Juniors must be
born on or after January 1, 1985
Cadets must be born on or after January 1, 1988
TOTAL ENTRY FEE
$_________________________
PLEASE NOTE THAT
ENTRIES WILL NOT BE ACCEPTED WITHOUT FULL PAYMENT.
ENTRY DEADLINE:
MARCH 15, 2003
For further information please contact:
| Debbie Moya | USATT Director of Programs |
| Phone | 719-866-4583 |
| Fax | 719-632-6071 |
| programs@usatt.org |
Please send your
entry form, entry fee and the signed Release & Waiver form to:
USA Table Tennis
One Olympic Plaza
Colorado Springs,
CO 80909
USA
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