Tournament Entry Form

Name:_____________________________ Phone: ____________________________

Address: __________________________   City: _________________ Zip: _________

Email: _______________________________________________________________

School: __________________________________ Grade: ______________________

Date of Birth: ____________________ Rating: ______________ (if known)

USATT ID # (if known) :__________

 

Event numbers:		Event Fee:
__,___,___,___		$__________
Rating fee: (Required)		$__($5.00___
USATT Membership fee*		$__________
	Total:	$__________

* If required, fee is $20 for all students including college: First time students under 19 will be sponsored by PTTC and need pay only $1. For non-students 19 and over, the fee is $40.

I will abide by all USATT regulations and release and hold harmless USATT and PTTC from liability for injury to persons or property damage.

Signature: __________________________________ (Parent Signature necessary if under 18.)

Please return Entry Form and check by August 20th to Mark Kobernick PO Box 82823, Portland OR 97282. Make checks out to PTTC.

 

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