LA Open Table Tennis Tournament 2011 Registration Form

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LA Open Table Tennis Tournament 2011

POWERED BY JOOLA

A USATT 4 STAR TOURNAMENT SEPTEMBER 3,4 2011

Event Event Name Date Time Fee 1st 2nd 3rd-4th 5th-8th 9th-16th
#

1 Over 60 RR Sat 08:00:00 AM $30.00 $400.00 $200.00 $100.00


2 Under 21 RR Sat 08:00:00 AM $30.00 $300.00 $150.00 $75.00
3 Open Doubles * Sat 10:30:00 AM $30.00 $1,000.00 $500.00 $200.00
4 Under 1750 RR Sat 10:30:00 AM $30.00 $300.00 $150.00 $75.00
5 Under 2500 RR Sat 01:00:00 PM $30.00 $600.00 $300.00 $150.00
6 Under 1550 RR Sat 01:00:00 PM $30.00 $200.00 $100.00 $50.00
7 Over 40 RR Sat 03:30:00 PM $30.00 $500.00 $250.00 $125.00
8 Under 15 RR Sat 03:30:00 PM $30.00 $100.00 $50.00
9 Open Singles RR Sat 06:00:00 PM $100.00 $12,000.00 $6,000.00 $2,000.00 $800.00 $400.00
10 Under 2250 Sun 08:00:00 AM $30.00 $400.00 $200.00 $100.00
11 Womens Singles Sun 10:30:00 AM $50.00 $3,000.00 $1,500.00 $750.00 $300.00
12 Under 1900 RR Sun 10:30:00 AM $30.00 $300.00 $150.00 $75.00
13 Under 2050 Sun 02:00:00 PM $30.00 $400.00 $200.00 $100.00
(*) Open Doubles will be single elimination. Prize money is per team.
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Entry Deadline is Friday, August 19 2011

Name(Last, First): ______________________________________________________ Phone:___________________________

Address: ___________________________________________ City: _____________________ State: _____ Zip:__________

USATT Membership #: ____________ Expiration Date: __________ Rating(As of July – August 2011 Magazine): ________

Date of Birth: _____________ Email Address: _______________________________________ Club:____________________

I will abide by all regulations of the USATT and the Sponsors. I have signed (or will sign), the Release and Waiver of Liability
exempting the USATT and the Sponsors from any liability for injury to myself or to my property

Signature: ____________________________________________________________(Parent or guardian must sign for minor)

Event # Event Name Doubles Partner Fee Event Fees


Late Fee ($50 after 8/19)
Administration Fee $8.00
Rating Fee $7.00

Total Fees $

Make checks payable to “LA Open”. Send with completed entry form.

Mail to: LA Open For Information please call (818) 384-7408


Masaru Hashimoto.
9701 Arleta Ave.
Pacoima, CA 91331

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