Print
Out, Circle
Divisions Below and Fax to 307-265-0411
Pro = $80
Amateur = $50 (Max two divisions)
Men's Pro + One or Two Amateur Events = $130
Note: credit card information must accompany this fax - or phoned into the Wyoming Athletic Club (307-265-6928) so that it may be added to your faxed entry.
Please circle below the divisions you wish to enter
Womens: ----- Open ------- A B C 40+ 50+ Open/A Doubles B/C Doubles
Mens: Pro Open Elite A B C 40+ 50+ Open/A Doubles B/C Doubles
Juniors: Circle: A B C Novice Jr. Open/A Doubles Jr. B/C Doubles
Juniors: Circle: Male Female / Age [ ] Birthday _______/______/______
Entry Fee to be charged to my credit card =Pro_____________ + Amateur_______ = Total________
Please Print Clearly
Name:____________________________email______________________
Address:___________________
City:____________State:____________
Phone:
day:__________________evening:_________________________
Club
Affiliation:_______________ Shirt Size XXL XL L MED SM
VISA-MC-DISCOVER #______________________________________EXP___________
Signature:__________________________________ Date: ___________________
Tournament use only: Date Recieved by WAC_______________________