Friday, Saturday & Sunday, July 17-19, 2015
Women’s Doubles* & Men’s Singles* (Friday) | Mixed Doubles* (Saturday)
Men’s Doubles* & Women’s Singles* (Sunday)
Double Elimination; USAPA Rules; Doubles Skill Levels: 3.0, 3.5, 4.0, 4.5, 5.0; Singles (Open)
LOCATION: Toledo Pickleball Courts, Just north of the US Post Office at 313 Glenwood Rd, Rossford, OH
REGISTRATION FEE: $30.00 ($10 for each doubles events, $5 for singles)—nonrefundable,includes dri-fit shirt, water, snacks
Registration deadline: Must be postmarked by July 6, 2015.
Tournament Schedule: Registration Begins at 8:00 am, Play Begins at 9:00 am
* Event draws will be limited. In the event of inclement weather, matches may be held indoors.
Tournament Director: Connie Mierzejewski, 419-509-3023, email@example.com
Make checks payable to: Toledo Pickleball Club, ($30 registration fee, $10 for each doubles events, $5 for singles.)
Clip this entry form above at the line above and mail it no later than July 6th to:
Toledo Pickleball Glass City Invitational, c/o Connie Mierzejewski, 228 Hillsdale Ave., Rossford, OH 43460
ENTRY FORM - PLEASE PRINT
Name: ______________________________________________________________________________ Shirt Size: S M L XL XXL
City/State/Zip: _______________________________________ Phone: ____________________________________________
Email: ____________________________________________________________________________________ Gender: M __ F __
Singles: ___ Skill Level: ____ | Doubles: ____ Skill Level: ____ | Mixed Doubles: ____ Skill Level: ____
* (Please indicate your gender, the event(s) you are playing in and your skill level in the spaces above.)
Doubles Partner’s Name: ___________________________________________ Doubles Skill Level: _____
Mixed Doubles Partner’s Name: ___________________________________________ Mixed Doubles Skill Level: _____
PLEASE SIGN, DATE & RETURN THE WAIVER RELEASE FORM ON THE BACK OF THIS FORM
Name (Please Print)
Street City State Zip
acknowledge that I am aware that certain risks are or may be associated with activities sponsored by the Toledo Pickleball Club, and I personally
assume all such risks for the participation of myself in any activities in which I take part. I assume full responsibility to become educated regarding
the proper and safe use of any equipment associated with the activities in which I am involved, and the responsibility to abide by all safety rules
promulgated by the Toledo Pickleball Club in relation to said activities. I likewise assume full responsibility to obtain medical clearance from my
physician to participate in the activities offered by the Toledo Pickleball Club. In consideration of the permission granted to me by the Toledo
Pickleball Club to participate in the activities it sponsors, I hereby release the Toledo Pickleball Club and their agents, consultants or employees
from all actions, causes of action, damages, claims or demands which I or my heirs, executors or assigns may have against these entities/persons
for all injuries or property loss or damage which I may incur by participating in said activities.
I have read this informed consent/release of claims and understand its terms. I execute it voluntarily and with full knowledge of its significance.
In witness whereof, I have executed this release this ___________ day of _________________________________ in the year 2015.
Adult Guest Signature