TERRY BEGEMAN MEMORIAL PICKLEBALL TOURNAMENT FORM Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Date / TimeDateTimeAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSkill Level *Beginner (2.5 and below)Novice (3.0)Intermediate (3.5)Advanced (4.0 and above)Scroll to the bottom of this page to see a description of skill levels.Emergency Contact Name *Emergency Contact Phone *Are you a Member or Non-Member of CLAC? *Member - $35.00Non-Member - $40.00In the case of inclement weather, refunds will not be given. We appreciate your donation/support.All players must agree to this disclaimer regarding the facility, Canyon Lake Activity Center (CLAC), before beginning play I am aware that I am engaging in physical activity and that the use of Canyon Lake Activity Center's Pickle Ball courts and interaction with any part of the facility could cause injury to me. I am voluntarily participating in these activities and assume all risks of injury to myself that might result. I agree to waive any claims or rights I might otherwise have to sue CLAC, its officers, or employees for injury to me as a result of these activities. I have carefully read this waiver, which states that I assume all risks of injury. I am hereby advised that I should be sufficiently physically fit for exercise activities and participation in CLAC events. I understand that I should have consulted a physician prior to undertaking any physical exercise. Signature * Clear Signature Payment Information Would you like to attend the Post Tournament Shrimp Boil & Social? *YesNo$10/adults, $5/kids under 12 Cash Bar with beer and wine Players and Non-Players Welcome!Number of Adults Attending *1 - $10.002 - $20.003 - $30.004 - $40.005 - $50.00None - $0.00Number of Children Under 12 Attending *1 - $5.002 - $10.003 - $15.004 - $20.005 - $25.00None - $0.00Total$0.00Is the Billing Address the same your registration form? *YesNoBilling Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCredit Card *CardName on CardSubmit Pickleball Division Definitions
