Entry Form
2003 USA Table Tennis World and Pan Am Trials
Shown below please find the pertinent information and entry form for participation in the trials for the 2003 USA Table Tennis World and Pan Am Team.
Date and Time
Tentatively scheduled for February 12-15, 2003 (subject to change)
Location
The Sporting Club at Wendy Hill, 135 Interstate North Parkway, NW, Atlanta, GA 30339
Competition Format
12 athletes participating in a single giant round robin in which each athlete will compete against every other athlete. Each match will the best of seven games.
Equipment
Butterfly tables, Nittaku orange balls
Eligibility
In order to be eligible to participate in the 2003 USA Table Tennis World and Pan Am Team Trials, an athlete must:
Be a U.S. citizen, with the exception of those who were nominated to compete for the U.S. in international championships prior to August 31, 1997. There is some very technical fine print which accompanies this basic rule. If you are unsure of your eligibility, please contact USA Table Tennis for clarification.
Have on file at USA Table Tennis headquarters or submit with the entry form verification of eligibility (copy of photo page of U.S. passport, copy of U.S. birth certificate, etc.).
Be an current member of USA Table Tennis
Entry Process
A completed entry form (including proof of eligibility and $100 entry fee) must be received at USA Table Tennis headquarters no later than Wednesday, November 6, 2002.
Entry forms submitted without eligibility verification and $100 entry fee will be REJECTED.
Additionally, applicants selected to compete in the Trials must sign a 2003 Athlete Contract prior to the beginning of the competition.
The $100 entry fee will be refunded as follows:
To those who are not selected for participation in the trials.
To those who are eligible for and participate in the trials.
Refunds will be given via check issued from USA Table Tennis headquarters.
Distribution of Entry
This entry form and information packet is being distributed to the top 30 ranked males and females in the United States, regardless of eligibility status (see enclosed distribution list). It has been noted on the list which athletes do not have on file at USA Table Tennis headquarters proof of eligibility to participate in these trials. If an athlete wishes to enter the trials and there is an asterisk (*) beside his/her name, he/she MUST submit proof of eligibility along with the entry form and entry fee.
Invitations
After receipt of all entry forms, invitations will be extended to the 10 highest rated male and female applicants from all tournaments which were completed as of September 15, 2002. The two remaining spots at the trials will be reserved for two athletes of each gender who are successful at a separate qualifying tournament to be held for other eligible athletes who are not among the top 10 athletes eligible by rating.
This qualifying tournament will be held at the 2002 USA Table Tennis National Championships, Las Vegas, Nevada, beginning on December 18, 2002. Athletes who do not qualify as one of the top 10 athletes of each gender must enter the appropriate qualifying event at the 2002 USA Table Tennis Nationals. The deadline for this event is November 8 (without late fee) or November 15 (with late fee). Entries for the qualifying events will not be accepted after these dates.
Special Notes
By entering the 2003 USA Table Tennis World and Pan American Team Trials, each athlete agrees to participation in the following events (if successful in achieving a position on the team):
May 9-16 – Training Camp at a location to be determined
May 19-25 – World Championships, Paris, France
June 25-July 2 – Training Camp at a location to be determined
July 3-July 6 – U.S. Open
July 20-July 28 – Training Camp at a location to be determined
August 1-18 – Pan American Games, Dominican Republic
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2003 USA Table Tennis World and Pan American Team Trials
The Sporting Club at Windy Hill
135 Interstate North Parkway, NW
Atlanta, GA 30339
February 2003
All entries must be received at USATT Headquarters
no later than November 6, 2002
ENTRY FORM
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USATT No. |
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Name |
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Street Address |
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City/State/Zip |
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Telephone |
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E-Mail Address |
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Date of Birth |
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U.S. Citizen? |
Yes No |
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If paying by Visa or MasterCard, please complete the following information: |
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Name of Cardholder |
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Card No. |
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Exp. Date |
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Signature |
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ENTRIES WILL NOT BE ACCEPTED WITHOUT FULL PAYMENT AND ALL REQUIRED DOCUMENTATION
I will abide by all USATT regulations for tournament play. I understand that the following MUST accompany the above-completed entry form:
A signed Release & Waiver of Liability form (on reverse side)
Entry fee of $100
Verification of eligibility
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Signature of Participant |
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Parent’s Signature (if minor) |
Send completed entry form, Release & Waiver of Liability, entry fee, and verification of eligibility to arrive no later than November 6, 2002, to:
USA Table Tennis
One Olympic Plaza
Colorado Springs, CO 80909
* * * * * * * * * * *
USA Table Tennis
Release and Waiver of Liability, Assumption of Risk, and
Indemnity Agreement
("Agreement")
1. IN CONSIDERATION of being permitted to participate in any way in USA Table Tennis sanctioned events, I and/or my minor child, our personal representatives, assigns, heirs, and next of kin:
2. ACKNOWLEDGE, agree, and represent that I and/or my minor understand the nature of Table Tennis Activities and that I and/or my minor child are qualified, in good health, and in proper physical condition to participate in such Activity. I further agree that if at any time I believe conditions or equipment to be unsafe, I and/or my minor child will immediately discontinue further participation in the Activity.
3. FULLY UNDERSTAND that (a) TABLE TENNIS ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by me and/or my child's own actions, or inaction, or the actions or inaction of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I and/or my minor child incur as a result of my participation in the Activity.
4. HEREBY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS, AND/OR DAMAGES FOLLOWING SUCH INJURY, DISABILITY, PARALYSIS, OR DEATH, EVEN IF CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW;
5. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE USA TABLE TENNIS, their respective administrators, directors, agents, officers, officials, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I and/or my minor child, or anyone on my and/or my minor child's behalf, makes a claim against any of the Releases, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim.
6. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
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Signature of Participant (only if age 18 or over) |
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Signature of Parent/Legal Guardian (if participant is under age 18) |
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Printed Name of Participant |
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Printed Name of Parent/Legal Guardian (if participant is under age 18) |
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Date |
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* * * * * * * * * * *
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Distribution List for Entry Form |
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2003 USA Table Tennis World and Pan Am Team Trials |
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WOMEN |
MEN |
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No. |
Rating |
Elig |
Name |
No. |
Rating |
Elig |
Name |
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1 |
2631 |
Chang, Jun Gao |
1 |
2761 |
* |
Fan, Yi Yong |
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2 |
2507 |
* |
Wang, Chen |
2 |
2738 |
* |
Lupulesku, Ilija |
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3 |
2470 |
* |
Huang, Yao Xi |
3 |
2713 |
Cheng, Yinghua |
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4 |
2459 |
Banh, Tawny |
4 |
2712 |
Zhuang, David Yong-Xiang |
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5 |
2409 |
Reed, Jasna |
5 |
2707 |
Owens, Eric |
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6 |
2360 |
Yip, Lily |
6 |
2677 |
* |
Turbok, Attila |
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7 |
2352 |
* |
Peluchova, Renata |
7 |
2626 |
Butler, Jim |
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8 |
2349 |
* |
Sun, Angela |
8 |
2607 |
* |
Racz, Dezso |
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9 |
2329 |
Yang, Simone |
9 |
2603 |
* |
Musa, Atanda |
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10 |
2293 |
Sung, Virginia Wei-Ni |
10 |
2596 |
Sweeris, Todd |
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11 |
2274 |
* |
Wang, Jing |
11 |
2589 |
Nguyen, Khoa Dinh |
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12 |
2254 |
* |
Moseley, Kibibi Ione |
12 |
2583 |
* |
Oyebode, Michael |
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13 |
2245 |
Lee, Jacqueline |
13 |
2573 |
Hazinski, Mark |
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14 |
2245 |
* |
Bosika, Mimi |
14 |
2573 |
Cretu, Razvan |
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15 |
2237 |
Ping, Whitney |
15 |
2571 |
* |
Drinic, Sasa |
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16 |
2231 |
* |
Zhao, Hong |
16 |
2568 |
* |
Subonj, Viktorian |
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17 |
2231 |
* |
Wang, Li Jun |
17 |
2551 |
* |
Wang, Fei |
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18 |
2215 |
Do, Michelle |
18 |
2544 |
Rop, Darko |
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19 |
2172 |
Wu, Katherine |
19 |
2540 |
* |
Shiu, Arturo Pang |
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20 |
2145 |
* |
Garcia, Enerys |
20 |
2532 |
* |
Shao, Yu |
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21 |
2135 |
Chui, Jane Hone |
21 |
2531 |
* |
Hyatt, Michael |
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22 |
2133 |
Hugh, Judy |
22 |
2524 |
Huang, Tong Sheng Jack |
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23 |
2124 |
* |
Fong, Kyna |
23 |
2521 |
* |
Fernandez, David |
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24 |
2109 |
* |
Zheng, Pei Pei |
24 |
2514 |
Lonergan, Sean Michael |
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25 |
2109 |
* |
Li, Yongmei |
25 |
2509 |
Seemiller, Daniel Robert |
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26 |
2107 |
* |
Kretschmer, Maria |
26 |
2503 |
* |
Hylton, Stephen |
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27 |
2101 |
* |
Kabaeva, Anna |
27 |
2499 |
Jain, Ashu |
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28 |
2094 |
* |
Yi, Sophia Dan Dan |
28 |
2498 |
O'Neill, Sean Patrick |
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29 |
2056 |
* |
Ghiasi, Pegah |
29 |
2492 |
Xiao, Han |
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30 |
2049 |
* |
Yang, Xue |
30 |
2490 |
Alban, Keith |
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*No eligibility documentation on file |
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NOTE: Ratings include all tournaments played through September 15, 2002 |
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