2018 Knoxville Joseph Newgarden Memorial Summer Gold Dollar Upset Open Tournament Sign Up Form

To sign up for the tournament online, please complete the following information:

Fields marked with an * are required

First Name *

Last Name *

Address *

City *

State *

Zip / Post Code *

Email *

Phone

USATT#

USATT Expiration Date

Current Rating

Home Club *

Hotel Reservation Number

Tournament Fees:

Tournament Entry Fee $50 *

USATT Annual Membership

Early Bird Discount - minus $5

Hotel Discount - minus $10

Optional Donation to TT Team USA National Program

Total $

Total $
50.00

Disclaimer

By my participation, I hereby relieve the sponsors: USATT, Knoxville Table Tennis Club, the City of Knoxville, tournament director, and the tournament committee of any liabilities for injury to myself and/or property damage or loss. I agree to comply with all decisions of the tournament officials and abide by all USATT regulations. In lieu of participant signature, please type your name into the Participant Signature field to acknowledge the liability paragraph. If the participant is a minor (under 18 years old), please type in the Guardian or Parent Name instead.

Participant/Parent or Guardian (if minor) Signature *