Magic Spin Table Tennis http://www.magicspintabletennis.com 2-Star USATT Sanctioned Tournament on Saturday, October 25, 2014 Tournament Information and Requirements Director:------------------------Mr. Ardy Afshar; (949) 463-8000; [email protected] Referee:------------------------Mr. Joe Tran CR/IU Staff:----------------------------Mr. Vic Truong; [email protected] and Mr. Ardy Afshar Location/Venue:-------------Magic Spin Table Tennis Club, 6386 Industry Way, Westminster, CA 92683 Eligibility;----------------------All players must be USATT members or buy a one-time pass ($10) Registration & Deadline:-Using this form or online at http://www.omnipong.com; Deadline:--Oct 24, 2014 Event** st nd Date Time 1 Prize 2 Prize Fee/Player Name 1 U2100RR SAT 09:00 AM $100 $50 $15 USATT# 2 3 U1500RR SAT 10:30 AM T T $15 Expiration Date U1300RR SAT 12:00 PM T T $15 DOB (optional) 4 U1900RR SAT 01:00 PM T T $15 Club 5 6* U1700RR SAT 02:30 PM T T $15 Home Address U2500RR SAT 04:00 PM $200 $100 $20 City, State, Zip 7 8 U2300RR SAT 05:30 PM $150 $75 $15 Phone (Txt) U3700DBLE RR SAT 06:30 PM $150 $100 *Event 6 will use the new plastic ball type (non-celluloid): Nittaku 3-Star **Unrated players may participate in any event but will not advance. $15 Sub-Total $ Official Tournament Equipment: Butterfly Tables, Yellow 3-Star Balls, Red Mat Floor Last/First Email Add $7 USATT Fee & $5 Admin Fee Total Fee: $ RULES: THANK YOU FOR YOUR SUPPORT 1) All USATT & ITTF regulations, including equipment, conduct, dress code, and discipline apply. If not using www.omnipong.com, All matches are 11 pt. games, best 3 out of 5 games. please mail your registration form and 2) Ratings from the USATT October 10, 2014 will be used for qualifications. Event 8 is limited to make a check PAYABLE to: U2100 players only. The most recent rating will be used for draw. 3) Players may not enter two events with the same start time, and may play no more than 4 events. Magic Spin Table Tennis Club 4) Players must register at least 30 minutes before starting time. 6386 Industry Way All decisions by the tournament referee & committee are final. Westminster, CA 92683 5) Events may be canceled or combined if needed. Fees will be refunded if canceled. 6) All participants must read and sign a Liability Waiver to complete your registration. See below. USA Table Tennis Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement ("Agreement") 1. IN CONSIDERATION of being permitted to participate in any way in USA Table Tennis sanctioned events, I and/or my minor child, our personal representatives, assigns, heirs, and next of kin: 2. ACKNOWLEDGE, agree, and represent that I and/or my minor understand the nature of Table Tennis Activities and that I and/or my minor child are qualified, in good health, and in proper physical condition to participate in such Activity. I further agree that if at any time I believe conditions or equipment to be unsafe, I and/or my minor child will immediately discontinue further participation in the Activity. 3. FULLY UNDERSTAND that (a) TABLE TENNIS ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by me and/or my child's own actions, or inaction, or the actions or inaction of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I and/or my minor child incur as a result of my participation in the Activity. 4. HEREBY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS, AND/OR DAMAGES FOLLOWING SUCH INJURY, DISABILITY, PARALYSIS, OR DEATH, EVEN IF CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; 5. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE USA TABLE TENNIS, their respective administrators, directors, agents, officers, officials, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I and/or my minor child, or anyone on my and/or my minor child's behalf, makes a claim against any of the Releases, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim. 6. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT. ___________________________ _____________________________ ______________________________________________________________________________ Signature of Participant Print Name Date ___________________________ _____________________________ ______________________________________________________________________________ Signature of Parent/Legal Guardian (If Participant is under age 18) Print Name of Minor Child Date MAP and DIRECTIONS Magic Spin Table Tennis Club 6386 Industry Way Westminster, CA 92683