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May 20, 2012
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Team Leader Details
First Name *:
Last Name *:
Email Address *:
Address Line1:
Address Line 2:
City *:
Region:
Country *:
Afghanistan
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Postal Code:
Telephone:
Team Details
Team Name *:
Team Address:
Web Site:
Team Category:
Mens
Womens
Age Group:
35 years and up
45 years and up
55 years and up
Team playing level:
Social
Competitive
Semi-competitive
Once were competitive
Estimated Team Numbers:
Players:
Supporters:
Accommodation preference - please choose one hotel and indicate how many of each room type your team would like to book.
Promenade Hotel
Share Twin/Double:
Triple:
Dazzler-Libertad Hotel
Share Twin/Double:
Triple:
Aspen Tower Hotel
Share Twin/Double:
Triple:
Entry Type:
Team / Group
Individual
Registration Fee :
Per team/group of US$200. If entering as an individual US$30
Entry fees refundable, less an admistration fee of US$50, and must be advised in writing prior to June 30th, 2013.
Bank Transfer
Cheque or Bank Draft
Credit Card (PayPal)
Terms and conditions *:
I have read and agreed on
Terms & Conditions
of entry
Register
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