ChiSlam Spin Attack TTC
Table Tennis Open
The non-sanction tournament: Non USATT member required: Tournament Date: May 17 2015
Tournament Director: Ardy S.Taveerasert
Referee: Ardy S. Taveerasert
Chi Slam Spin Attack Table Tennis Club
Contact Person: 312-287-9852 Ardy
Tournament Location: ChiSlam TTC Club /Mr. Ping Pong
1647 W. Chicago Ave. Chicago IL60622
Email: [email protected]
Tournament Rules: USATT Rules
Website: www.chislamclub.com
Equipments : 5 Killerspin Tables / White 3 Star Balls
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ChiSlam Single Tournament
Schedule
Fees Prize # 1 2 Semi
1. ChiSlam Intermediate Open Sun May 17 2015 Start: 1pm-6pm
$20.00 Trophy T
T
( Under USATT 1600) > Woman ,Senior & Kids Under 18 years welcome for this tournament.
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Full Name ______________________________________________Phone_______________________
Address_______________________________________________Email__________________________
Sex: Male or Female Age:_____USATT Member#________USATT Rating_______Expired________
Chi-Slam Member: Yes or No. If No, Your club or sponsor’s name______________________________
Please circle the event # 1
Total Event Fees
$_____________
Balance Total $_____________
Pay in full by Check or Cash By Date Fri, May 15 2015 *No Credit or Refund
Make Check payable to A&S Chicago Inc. Mail to Address: 1647 W. Chicago Ave. Chicago IL 60622
Email: [email protected] or send directly to the Chi-Slam Table Tennis Club
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*All fees must be paid with your entry. Entry deadline Sun May 16 2015 8:00pm
* Call 312-287-9852 > Ardy, for last minute entry.
*All Players must register at control desk half an hour before the competition.
* Default Time, is start time.
* The event official has the right to modify or change the prize & cancel events if not enough entries.
* If the event is cancelled for any reason > ChiSlam TTC will refund the entry fee.
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Please Note: All participants must read and sign The Waiver & Release Form on the back of this page
“ChiSlam Spin Attack Table Tennis Club/ Tournament Assumption, Waiver and Release Form”
I hear by assume all risk and responsibility for my participation in this tournament, and I release any and all
sponsors, Chi-Slam TTC, A&S Chicago Inc, U Table Tennis.com, Mr. Flower &Mr.Ping Pong,Directors,
Referee and any volunteers from any claims, action or demands for any loss, damage, personal injury or
death. I understand and will abide by all Chi-Slam TTC rules and regulations and the decisions of the
referee and director.
I am at least 18 years old and I enter this agreement knowingly and voluntarily.
Print First name ________________________ Last name__________________________________
Signature____________________________________Date_________________________________
Parent/Guardian if player is under 18 Year Old /Name_____________________________________
Signature____________________________________Date_________________________________
*Check our table tennis products website: www.utabletennis.com> table tennis for U