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2010 New England Regional Championships

April 16 - 18, 2009

Nashua Athletic Club

596 West Hollis Street

Nashua, NH

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: .....................Age:

You are allowed to play up to 2 events. For each event please pick only 1 from the 3 event types; Skill Level, Age Group / Skill level or Doubles.

Please pick one event from the pull down menu below.

Select your First event: Select a Skill Level OR pick an age division and skill level OR pick a doubles event

First Event Doubles Partner

Please pick one event from the pull down menu below.

Select your Second event: Select a Skill Level OR pick an age division and skill level OR pick a doubles event

Second Event Doubles Partner

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