Name of your Club :                                          

Name of Large City near your practice facilities: 

Club Website Address, if one:                           

Primary Director Information- all fields required

First Name:   Last Name:

Address:   City:   Zip:

Home Phone:   Work Phone: Cell:

Home Email:   Work Email:

Secondary Director Information (if you have another director or someone who needs to be copied club information)

First Name:   Last Name:

Address:   City:   Zip:

Home Phone:   Work Phone: Cell:

Home Email:   Work Email:

Do you have interest in hosting a junior tournament ? Maybe Yes No

Do you have interest in hosting an adult tournament? Maybe Yes No