19th BOB VIDUCICH  STIGA PACIFIC RIM OPEN
 November 3 & 4, 2007   USATT FOUR STARS TOURNAMENT

SEND THIS FORM 


 ENTRY FORM:  BOB VIDUCICH STIGA PACIFIC RIM 2007



Entry deadline is October 30, 2007


Name:__________________________________________________  


Address:__________________________________________________________


City, State, Zip:___________________________________________________  


 Phone: __________________________Birthday _____/_____/____


E-Mail Address ___________________________________________


USATT Membership No. ____________________USATT expiration date  _____/_____/_____


Rating (if known)________________  


All participants must be USATT or ITTF affiliated members.  If not a member of USATT or ITTF you must join USATT.  

All USATT regulations apply.

All decisions by the tournament committee is final.


Enter Your Doubles Partner’s Name


Open_______________________Mixed___________________________2400________________________


3200________________________4000____________________________


Events Entered (write event number):  ____, ____, ____, ____, ____, ____, ____, ____, ____, ____, ____


Description

Fee

Mandatory USATT Rating Fee

$  5.00

Mandatory Official’s Fee

$  1.00

USATT membership (if required) $40.00for adult or $20 for youth or $60 for a household

$

Event Fees (add all entry fee for all events)

$

Donations for improved PAC RIM in 2008

$

Total Tournament Fees (thank you)

$


Send Entries and Checks To:  


Ken Ping/ PTTC

16635 NW Yorktown Dr.

Beaverton, OR 97006



Make checks payable to the Portland Table Tennis Club. Entries without checks will not be included in the draws.


I will abide by all USATT regulations.  I accept full responsibility for my participation and relieve the sponsors and the USATT from any liability for injury to myself or damage to my property.  If a player is under age 18, their parent or guardian must sign.


Signature:_____________________________________   Date:______________________________________

PLAYERS MUST SIGN THE USATT WAIVER  WHEN THEY CHECK IN

 

RETURN TO PREVIOUS PAGE