USTA/Southern Section Standard Entry Form To go back to the events page Click here.
This entry blank may be printed out and used for entry into USTA/Southern Section sanctioned  events. 
Entry to all tournaments requires proof of current USTA membership.

Tournament Name: _________________________________________________ Tournament Dates: _______________ 

Player's Name: ____________________________________________________ 

USTA #: __________________________ Expiration Date: __________________ 

Address: ________________________________________________________ 

City: ________________________ State: _______ Zip: _________________ 

Phones (H) _______________________ (O)____________________________ 

Date of Birth: __________________ Current Rankings: (District)________ (Sectional)________ (National)________ 
  Adult / Senior Championships

Mens' [__] Singles Age Group: ______ or NTRP Level [___] 

Womens' [__] Singles Age Group: ______ or NTRP Level [___] 

Doubles Age Group: _____ . . . Partner's name: _______________ [__] Need Doubles' Partner  

Mixed Doubles Age Group: _____ . . . Partner's name: _______________ [__] Need Mixed Doubles' Partner 
  Junior Championships

Girls' [__] Boys' [__]      10    12    14    16    18 

Singles Age Group: ______Doubles Age Group: _______ Partner's name: _______________ Need Doubles' Partner [__] 

Medical Release: I hereby consent to emergency medical and/or hospital service that may be rendered by or at accredited hospitals, by appointed physicians, in the event such need arises in the opinion of a duly licensed physician. 
Waiver and Indemnity Agreement: Acceptance of my entry in these events is without responsibility of any kind by the USTA, the USTA/Southern Section, the host clubs, committees, or the management of any event in which I may be entered or may participate. In consideration of the acceptance of my entry, I do hereby for and on behalf of myself and my heirs and legal representatives release and forever discharge the USTA, the USTA/Southern Section, and the host clubs, their officers, committees, and representatives and their successors and assigns, of and from any and all claims, demands, and injuries, however arising, whether caused by the negligent or intentional acts of the USTA, USTA/Southern Section and its representatives, representatives of other sponsoring entities, or by third parties, which injuries may be in any way related to my activities during the tournament and any period traveling to or from the events described, and all such claims are hereby waived and released, and I covenant not to sue therefore. The parent or guardian, by signing below, does hereby agree to indemnify and hold harmless the USTA, USTA/Southern Section and its representatives and the sponsoring entity from any liability which they may incur to the entrant, howsoever arising and whether caused by the negligent or intentional acts of the USTA, USTA/Southern Section, its representatives, or the sponsoring body. I understand that this tournament will be governed by applicable USTA rules and regulations, the rules and regulations of this tournament, the rules and procedures governing discipline of players in USTA/Southern Section  sanctioned tournaments, the USTA/Southern Section and district code of ethics, tournament policy, and ranking regulations and agree to conduct myself accordingly. I have read and understand the foregoing medical release, waiver and indemnity agreement.  

Signature of player (or parent if under 18): _________________________________Date: ____________