Surname |
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| Given Name |
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Male
Female |
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Local Club
Date
of birth
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dd.mm.yy
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| Address1
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| Address2 |
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| Town |
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| Postcode |
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| Home
Phone |
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Phone during tournament
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Tennis Seniors
Registration no.
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| Email
Confirm
Email
Events Entered
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Singles |
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Monday
Mixed |
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Partner.................
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Tuesday
Doubles |
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Partner.................
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Wednesday
Combined |
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Partner.................
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ITF Seniors
Ranking |
Check your latest ITF seniors ranking
here
If you do not have an ITF ranking or
state seniors N ranking type none |
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** State and
State Registration
number eg
NSW 245321 |
If you are not a member you must pay the
non member fee
in the additional fees selection below. |
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Special requests.
Player
History
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For seeding purposes, please list below details of
your relevant record of play including wins and
losses for the last 12 months. Kindly include the name of
your opponent in each case. Include your current
world and national ranking if applicable
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Player Release |
Player Agreement & Release
I acknowledge
that as a participant in the Merimbula Tennis Clubs Seniors
Championships I
am required to comply with various rules, regulations and policies
as listed on the entry form (link above). I certify I am a
registered member of the nominated Tennis Seniors Association (see
* above).
In consideration of your agreement
to allow me to participate in the Merimbula Tennis Clubs Seniors Championships ("the event"), I hereby agree, in submitting
electronically this entry form into the Event, as a condition of
participation in the event, that for me and my executors, administrators, heirs and
personal representatives, all claims of any kind, nature and
description are waived, including past, present or future claims and
injuries , if any, sustained in travelling to or from participating
in the Event, against Tennis Seniors NSW, Tennis Seniors Australia,
The International Tennis Federation, Tennis NSW, Tennis Australia or
participating clubs.
Type
I agree
in the text box below to acknowledge your acceptance of the player
agreement & release above.
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Additional Fees
Dinner Tickets
Payment
Method
Total
Entry Fee
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Visa
Mastercard Paypal
Cheque
Money Order
Visa, Mastercard or
Paypal
payments to be made below with the Pay Fees button.
Cheques or Money order payments to be posted to
Merimbula Tennis Club, PO Box 231 , Merimbula, NSW 2548
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