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Ohio Cleveland,
OH |
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Entry form
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Maps
and Directions
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| Print this page and complete sections below. | Mail
payment with form to: |
Jim Corrigan Phone: 216-789-5104 (cell) | |
| Name | ||
| Address | ||
| City, ST Zip | ||
| Daytime Phone | ||
| Home Phone | ||
| Division 1 | ||
| Division 2 (if desired) | ||
| Partner | ||
| Waiver | The undersigned, in consideration of this event being accepted, hereby assumes all responsibility for any and all risk of damage or injury that might occur arise from participation in the above event. The undersigned specifically releases and discharges the Severance Athletic Club, and it's employees and affiliates, the USHA, and tournament committee, and their agents, representatives, successors or assigns, for any and all injuries which may arise from participation. | |
| Signature | ||
| Date | ||
| ___ I can play early on Friday night | ___ I can play early Saturday morning | |
| Best starting time for me | ||
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