Name: ____________________________________________________
Address: _________________________________________________
City:__________________________
State:_____ Zip:___________
Phone: (_________) ___________________________
Email: ________________________________@_______________
(primary correspondence will be by email)
GLTA
ID #: ___________________
Club Affiliation (if any): ________________________________
Division (circle):
Open A B C D
Select Shirt Size (circle): S M L XL XXL
Partner:__________________________________
WAIVER: In consideration of being allowed to participate in the Long Beach Pride Doubles 7 tennis tournament
and related activities and events, I agree to release the Gay and Lesbian Tennis Alliance (GLTA), private and public facilities
or any individuals connected with the GLTA event from assumption of responsibility and waive any rights and claims for bodily
and emotional harm that I might suffer. I also understand that this event is enforced under USTA/GLTA rules and regulations
and I agree to conduct myself accordingly. Finally, I accept
that after May 2nd, there will generally be no refunds to players who need to withdraw unless circumstances are
exceptional and paying replacements found.
Signature: ____________________________ Date: ________________
(must be at least 18 years old to play without written approval from
parent or guardian)
Fee per player (make check payable to "Long Beach Pride Tennis")
Entry Fee: $69
(includes $4 GLTA fee required per player)
* See DETAILS page for refund guidelines; no full refunds after entry deadline.
Sign waiver and mail entry form/fee to:
Long Beach Pride Tennis
c/o Rogeve Gulati
3350 East 7th Street #113
Long Beach, CA 90804
NO REFUNDS AFTER MAY 2nd.
EMAIL lbpridetennis@yahoo.com for more info.
