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2005 Green Country Doubles Entry Form
Print this form out and send it in with your entry fees

Player #1 Name________________________________________      PDGA#______________
box Member - current        
Address______________________________________________    box Member - not current

City__________________________________   State_________   Zip____________________


Telephone (             )_____________________   E-mail________________________________


Player #2 Name________________________________________      PDGA#______________
box Member - current        
Address______________________________________________    box  Member - not current

City__________________________________   State_________   Zip____________________


Telephone (             )_____________________   E-mail________________________________

Check ONE:
box Open
box Advanced
box Amateur
box Recreational (Novice)
box Mixed (Male & Female)
 
$130 per team
$100 per team
$80 per team
$50 per team
$50 per team
 
Player #1   PDGA membership required or additional box $5 fee
Player #2  
PDGA membership required or additional box $5 fee

Check all that you want to enter:
Player #1   box Ace Pot $4.00    box CTP $4.00
Player #2   box Ace Pot $4.00    box CTP $4.00


TOTAL:  $_____________

WAIVER
I understand that upon signing this waiver I release Tulsa Disc Sports Association, the City of Tulsa, Tulsa Parks Department, Tulsa County Parks, McClure Recreation Center, the YMCA, the PDGA and all others associated with this tournament from any and all liabilities should I become injured in this tournament. I also understand upon signing that I will abide by all PDGA rules and realize that if I do not, I will be penalized according to the rules set forth by the PDGA.

Player #1 Signed:____________________________________

Player #2 Signed:____________________________________

Mail this entry form with your check or money order made payable to Michael Barr to:

Michael Barr
8907 N. 125th E. Ave.
Owasso, OK  74055

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