Eurobodalla District Tennis Association Inc Proudly Presents

Eurobodalla District Tennis Association Inc Proudly Presents:2011 Moruya Country Markets Seniors TournamentEntry Form - Entries Close Friday 12 th August, 2011Name.................................................Male/Female.......Date Of Birth......./......../.......Address.................................................................................PostCode............Phone (Home)...................................................Mobile......................................Email Address..................................................................................................Contact details while in Moruya area (address/phone)...............................................Your Tennis Club......................Division/Grade.........National Player Rating (if known).......(Entry must be accompanied by fees)Please enter me in the following events (Your partner must fill in a separate entry form)Friday 26 th :Saturday 27 th :Sunday 28 th :EventAgeGroupPartner’s NameSingles ---------------------------------------------------- $Mixed Doubles $Doubles $Combined Age Doubles $Combined Age Mixed Doubles $State Player Registration No.: (e.g. TennisNSW)If not currently registered, $22.00 registration fee applies ....................................State Tennis Seniors Registration No.: (e.g. Tennis Seniors NSW)If not currently registered, $10 temporary registration fee applies ...........................Saturday Night Dinner at Bowling Club No. Attending:- .......... @ $25.00 p.p. $Additional Monster Prize Draw tickets- $2 each or 3 for $5 (see over for details):(all ticket sales in support of Eurobodalla Cancer Care Centre - Moruya Hospital)Please find herewith total cheque/money order (made out to “E.D.T.A.”) for: $Fee Enclosed($10 perevent perperson)Player Agreement (this agreement must be signed by the player only)In consideration of your agreement to allow me to participate in E.D.T.A.’s “Moruya Country Markets Seniors Tournament”,I hereby agree in submitting an entry form into the Tournament, as a condition of entry for myself and my executors, administrators,heirs and personal representatives, all claims of any kind are waived, including past, present or future claims and injuries, if sustained intravelling to or from or participating in the Tournament, against Eurobodalla District Tennis Association Inc, Tennis Seniors NSW,Tennis Seniors Australia, Tennis NSW and host venues.I confirm that I have read the above Terms, Rules and Conditions and agree to abide and be bound by them together with the conditionsof entry, provided with this form.Name of Player........................................... Signature...................................Date...............$$$