February 3-4, 2017
PRE-SUPER BOWL Doubles Tennis Tournament
February 3-4, 2017 West River Community Center Indoor Tennis Courts, Dickinson, ND $25/1st Event — $10/2nd Event *Entry fee is per player Entry Deadline: January 26, 2017 Register Online at www.dickinsonparks.org
QUESTIONS? CALL 701-456-2074 Email: [email protected] 2004 Fairway Street, Dickinson, ND 58601 OFFICE USE:
Pre-Super Bowl Tennis Tournament February 3-4, 2017
- ENTRY FORM 1st Event Name
Age
Mailing Address
Phone
Amount Paid $_______________ Cash___ Check #____ CC____
POS Receipt #_______________
Email
City, State, Zip
Doubles Partner
Age
Shirt Size (circle) ADULT: S M L XL XXL
YOUTH: S M L
Division(s) – Please circle – Tournament committee has the right to combine or divide all divisions. Doubles High School
Doubles Women
Doubles Men
Mixed Doubles
.
2nd Event Name
Age
Mailing Address
Phone
Email
City, State, Zip
Doubles Partner
Age
Shirt Size (circle) ADULT: S M L XL XXL
YOUTH: S M L
Division(s) – Please circle – Tournament committee has the right to combine or divide all divisions. Doubles High School
Doubles Women
Doubles Men
Mixed Doubles
.
Waiver: I hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims I may have against Dickinson Parks and Recreation, West River Community Center, their representatives and sponsors, for any and all injuries suffered by me in connection with this tournament. ______________________________________________ Signature Date
__________________________________________________________________________ Parent Signature (if under 18) Date
February 3-4, 2017 West River Community Center Indoor Tennis Courts, Dickinson, ND $25/1st Event — $10/2nd Event *Entry fee is per player Entry Deadline: January 26, 2017 Register Online at www.dickinsonparks.org
QUESTIONS? CALL 701-456-2074 Email: [email protected] 2004 Fairway Street, Dickinson, ND 58601 OFFICE USE:
Pre-Super Bowl Tennis Tournament February 3-4, 2017
- ENTRY FORM 1st Event Name
Age
Mailing Address
Phone
Amount Paid $_______________ Cash___ Check #____ CC____
POS Receipt #_______________
City, State, Zip
Doubles Partner
Age
Shirt Size (circle) ADULT: S M L XL XXL
YOUTH: S M L
Division(s) – Please circle – Tournament committee has the right to combine or divide all divisions. Doubles High School
Doubles Women
Doubles Men
Mixed Doubles
.
2nd Event Name
Age
Mailing Address
Phone
City, State, Zip
Doubles Partner
Age
Shirt Size (circle) ADULT: S M L XL XXL
YOUTH: S M L
Division(s) – Please circle – Tournament committee has the right to combine or divide all divisions. Doubles High School
Doubles Women
Doubles Men
Mixed Doubles
.
Waiver: I hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims I may have against Dickinson Parks and Recreation, West River Community Center, their representatives and sponsors, for any and all injuries suffered by me in connection with this tournament. ______________________________________________ Signature Date
__________________________________________________________________________ Parent Signature (if under 18) Date
