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Tournament:

ROBOPONG 2010 MARCH BROWARD TABLE TENNIS TOURNAMENT

Organized by Broward Table Tennis Club, Inc. A non profit corporation.

Sanctioned By:

USATT

Stars:

When:

Saturday and Sunday, March 13th and 14th, 2010

Where:

SFTTO Facility

4200 NW 29th Ave., Hollywood, FL 33021

Click here for Map

Web:

http://www.BrowardTTC.net

Contact:

czeller@BrowardTTC.net

954-849-5436

Sponsored By:

Robopong	boutbox.com
eat2go.com

Director:

Carlos Zeller

Committee:

Carlos Zeller, Marty Prager, Terese Terranova

Referee(s):

Terese Terranova (NR./IU)

Eligibility:

Open to all members of USATT. Non members may join by paying the membership fee

with this entry. All events are rated events.

Rules:

The rules of Table Tennis as published by the ITTF and all USATT regulations

shall apply. All Matches are best of 5, 11 points each.

Equipment:

USATT approved equipment. 14 Killer Spin tables and nets. Wood florring.

40 mm orange Nittaku Platinum 3 Star ball.

Clothing:

USATT dress code applies.

Entry Deadline:

03/10/2010

Entry Not Accepted After:

03/10/2010

Late Fee: 0.00

Registration Fee:

4.00

Rating Fee:

7.00

Maximum Entries:

Player Information:

First Name:

Last Name:

Street Address:

City, State, Zip/Province:

Phone:

Country:

Gender:

Male Female

Birth Date:

My Membership Expires:

I have a lifetime membership:

Player Number:

eMail:

Confirm eMail:

Password:

Confirm Password:

Association:

Club:

My Rating:

Doubles Partner:
(if applicable)

Association Dues:

Select	Category	Fee
	Adult (1 year)	40.00
	Adult (3 years)	105.00
	Junior (1 year)	20.00
	Junior (3 years)	50.00
	Collegiate (1 year College/Grad Student)	20.00
	Millenium (Lifetime)	650.00
	Over 70 (Lifetime)	100.00
	One Time (Trial)	10.00
	None	0.00

Events:


Events Total:	0.00
Dues:	0.00
Registration:	4.00
Rating Fee:	7.00
Total:	0.00

Payment Terms:

Late charge of $7.00 will apply after the entry deadline, and NO ENTRIES will be accepted after the entry deadline. A $20 service charge will be made on ALL returned checks. MAIL YOUR PAYMENTS TO: CARLOS ZELLER, 3735 N. 37TH TERRACE, HOLLYWOOD, FL 33021. In the future you will be able to provide an electronic check or a credit card.

Waiver of Liability:

Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement 1. IN CONSIDERATION of being permitted to participate in any way in USA Table Tennis sanctioned events, I, our personal representatives, assigns, heirs, and next of kin. 2. ACKNOWLEDGE, agree, and represent that I understand the nature of Table Tennis Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree that if at any time I believe conditions or equipment to be unsafe, I will immediately discontinue further participation in the Activity. 3. FULLY UNDERSTAND that (a) TABLE TENNIS ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENTDISABILITY, PARALYSIS AND DEATH (‘RISKS”); (b) these Risks and dangers may be caused by my own actions, or inaction, or the actions or inaction of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE ‘RELEASEES” NAMED BELOW; (c) there may be OTHER RISKS AND SOCIALAND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLYACCEPTANDASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur ass result of my participation in the Activity. 4. I HEREBY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS, , AND/ORDAMAGES FOLLOWING SUCH INJURY, DISABILITY, PARALYSIS, OR DEATH, EVEN IF CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE”RELEASEES” NAMED BELOW; 5. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE USA TABLE TENNIS, their respective administrators, directors, agents, officers, officials, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners, and lessors of premises on which the Activity takes place, (each considered one of the “RELEASEES” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MYACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDINGNEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, ANDINDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releases, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACHOF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim. 6. AGREE TO FORFEIT ENTRY FEES TO USA TABLE TENNIS, should my registration not follow the stated registration procedure correctly. If I should sign up for TWO OR MORE EVENTS WITH THE SAME START TIME and/or sign up for MORE EVENTS THAN ALLOWED IN SEQUENTIAL ORDER, I understand that no refund will be issued and the Tournament Committee has the right to chose on my behalf which events are to be played. 7. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, ANDHAVE SIGNED IT FREELY AND WITHOUTANY INDUCEMENT ORASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONALRELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BEINVALID THE BALANCE NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. I will abide by all USATT regulations for tournament play. I am prepared to compete against any other participant, regardless of nationality or religion. - I have a valid passport for United States - I accept that my name may be published in the participants list on the Internet and/or elsewhere in print. ALL ENTRANTS MUST SIGN THIS WAIVER

Please Note:

Events 4 and 7 may carry over to Sunday.

Agreement:

I agree to abide by the terms set forth in this Registration Form.

eSignature:

Date: