Registration Form

PoCoMo Wheelchair Tennis Classic

ITF NEC WHEELCHAIR TENNIS TOUR EVENT
SCOTIABANK CANADIAN CIRCUIT

Player Name

IPIN # (required)

Date of Birth (d/m/y)

Nationality

Address

Prov/State

E-Mail

Postal/Zip Code

City

Country

Fax#

Phone#

T-Shirt Size Unisex:

DIVISION Women’s Main, B, & Quad Divisions dependent on the number of entries.

Men’s Main Draw

Second Draw

Women’s Main Draw

A Draw

B Draw

Quad Draw

Developmental Division/juniors

Do you have a current ITF Ranking in

NOTE: Draws maybe combined if necessary.

Singles

Doubles

Doubles Partner

Do you want us to find a doubles partner if possible?

Social Event

An event social will be held Saturday evening following the day’s matches.
Additional tickets are available at a cost of $25.

I will be attending the event social on Saturday evening

I would like to order extra tickets for the social. #

Payment Information

(Deadline for Registration: July 20th, 2011)

Player entry

Development/Junior Entry

Additional Social Tickets

Total Payment

Sent in Cheque

Will pay at Registration

.... make cheques payable to PoCoMo Youth Services Society (memo line put wheelchair tennis)

Mail To Address: Jerome Bouvier c/o PoCoMo Youth Services PO Box 715 Port Coquitlam, BC, V3B 6H9 Canada

Player Transportation Form

Organizers must have this information no later than July 10Th, 2011 to ensure pick-up from the airport.

I request Transportation to and from the hotel & tennis courts

I request Transportation to and from the Airport

I require a lift equipped vehicle for transportation

(if this information is not provided you will not be picked-up from the airport)

Flight Information

Airline:

Arrival Date

Arrival Time

Flight #

Airline:

Depart Date

Depart Time

Flight #

Please Complete all the information

PoCoMo Hours of Operation: