First Name: Last Name:

Address: City: State: Zip Code:

Home Club: USAR Membership No:

E-Mail Address:

Daytime phone No. Evening or Cell phone No.:

Junior Information: ................Choose One: NONE Boy Girl .....................Age: NONE 6 7 8 9 10 11 12 13 14 15 16 17 18

I can play Friday night at: 6PM 7PM 8PM 9PM I Can't Play

There is a 2-event limit in this tournament. Please select your events below, if you are only playing one event please select No Second Event from the list of events.

Please pick one event from the event selection below.

First Event Doubles Partner

Please pick one event from the event selection below.

Second Event Doubles Partner

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