ChiSlam Intermediate
Table Tennis Open
The non-sanction tournament: Non USATT member required: Tournament Date: Feb21 2016
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: Tournament Rules: USATT Rules
Website: 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 Feb 212016 Start: 11am-3pm $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 Feb 192016 *No Credit or Refund
Make Check payable to A&S Chicago Inc. Mail to Address: 1647 W. Chicago Ave. Chicago IL 60622 Email: or send directly to the Chi-Slam Table Tennis Club
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*All fees must be paid with your entry. Entry deadline Sat Feb 21 2016 6:00pm
* 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.
*********************************************************************************** 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: table tennis for U