Interclub Registration

Name:     Member Number

Email Address:

Home Phone:

Work Phone:

Cell Phone:

If you are interested in being a captain, please check here..

Team One:  I.C. Level 3.0 3.5 4.0 4.5 5.0 S/D: Singles Doubles   Day & Time:

Team Two:  I.C. Level none 3.0 3.5 4.0 4.5 5.0 S/D: none Singles Doubles   Day & Time:

Team Three:  I.C. Level none 3.0 3.5 4.0 4.5 5.0 S/D: none Singles Doubles   Day & Time:

New Doubles Partner’s Name
(Partner should complete a Separate Form)

If you do not want to remain with the same partner, on the same team, at the same level, please indicate your intention and reason below: