Please enter us in the events indicated. Enclosed is the sum of $_______ for entry fees.
Make check payable to SCHA and mail to: 503 38th Street, Newport Beach CA 92663.

Name__________________________________ Age______ Phone______________

Address______________________________________________________________

City______________________________ State__________ Zip________________

Partner Name___________________________ Age______ Phone______________

Partner Address_______________________________________________________

City______________________________ State__________ Zip________________

[ ] Tournament and Dinner $45

[ ] Tournament Only $20

[ ] Dinner Only $30

[ ] Join the SCHA $20

Waiver: Acceptance of this entry releases the Los Angeles Athletic Club, SCHA, their agents and successors from any liability for injuries that we may incur during said tournament.

Signature: _______________________________________________ Date: ___________________

Partner: _________________________________________________ Date: ___________________

Instructions: Please print this form, fill it out, and mail it along with all entry fees. To print this page on a single sheet of paper, reduce the size to 80%.