ENTRY FORM: Make copies for all additional entries:

MIXED DOUBLES CHAMPIONSHIP LEVEL A LEVEL B	ROUND ROBIN FORMAT Saturday, July 12 at 4:00pm

Finals on Sunday, July 13 at the Inwood Country Club Note: Championship level is 4.5 - 5.0, Level A 4.0, Level B 3.5 NTRP Ratings

TEAM REPRESENTATIVE: You will be responsible for notifying your partner(s) of playing times
Name: Birth Date:
Address: City: State: Zip:
Telephone: Home Work:
Cell: Email:
Club Affiliation: Phone:
Name of Club Pro: NTRP Rating:

DOUBLES PARTNER:
Name: Birth Date:
Address: City: State: Zip:
Telephone: Home Work:
Cell: Email:
Club Affiliation: Phone:
Name of Club Pro: NTRP Rating: