Submitted by thadmin on Tue, 03/23/2021 - 09:18 Full Name Full Name Age USTA Member Yes No Guardian’s Name Guardian’s Name What is the relationship with a minor Guardian’s Phone Number Email Address Does the minor have any medical condition that can prevent him/her from participating in the tournament Yes No Emergency contact Name Emergency contact Name Emergency Phone Number Relationship to the minor CATEGORIES (Please Check One) BOYS 10U BOYS 12U GIRLS 10U GIRLS 12U Acknowledgement & FEE 1. By participating in the tournament, I agree to assume full responsibility for any risk, injuries or damages, known or unknown, which a minor might incur as a result of his/her participation in the tournament. 2. I agree to pay a registration fee of $100. Submit Please pay a $100 Tournament Registration Fee