Richland, WA Tri-City Table Tennis Tournament     ENTRY FORM

Name: _______________________________________  Home Phone:   _______________

Address:  ________________________________________________   Club initials _______

City:  ______________________  State:  _____  Zip:  ___________

USATT ID #: _____________  Exp. Date ____/____/____   USATT Rating  ________

Birth date:  ____/____/____     Gender:  M   F   (circle one)

I will abide by all USATT regulations.  I accept full responsibility for my
participation in this event and relieve the sponsors and the USATT from any
liability for injury to myself or damage to my property that may result from
my participation in this tournament.

Signature: _________________________________________     Date ____/____/____
       (Parent / Guardian must sign for a minor (under 18))


USATT Membership Fees:
Adult   1 year   $40.00     Family 1 year   $60.00     Jr. U/15  3 years $50.00
Adult   3 years $105.00     Family 3 years $150.00     Jr. U/18  1 year  $20.00
College 1 year   $20.00

A Junior is under 18 as of previous July 1.
You may purchase USATT membership with this form.
Rating fee is mandatory.


Entry Options, ($30) ___ Saturday only
check only     ($25) ___ Sunday only
one:           ($30) ___ Saturday only, but will play Sunday if Saturday is full
               ($25) ___ Sunday only, but will play Saturday if Sunday is full
               ($50) ___ Saturday and also Sunday if Sunday is not full
               ($50) ___ Sunday and also Saturday if Saturday is not full
               ($50) ___ Both Saturday and Sunday only

Make check payable to T.C.T.T.A.              Fees:   Entry: $  ________
and mail to:                                         Rating: $     7.00 
   Mary Ann Parker                               Membership: $  ________
   2304 Snohomish Ave.                                        _____________
   Richland, WA  99354
   (509) 375-1587                                     Total: $  ________


P.S.    If you would like to communicate via e-mail put your e-mail address below
_________________________________________   ours is:   slvrfox@owt.com