Fox Valley Open Registration Form

Please fill this form before printing to make it more legible and then print it via browser's Print function.
This form is used for mail-in registrations only.

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First Name:     Last Name:    Age:  

Street Address:  City: 

State:    Zip Code:    Phone Number: 

E-mail:    Club where you play: 

Level (check one)  Junior (under 15)  Amateur  Intermediate  Advanced

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Players aged 13 years and older - $25, younger than 13 - $20.

Please make the check payable to Swavek Lorenc.  Mail the check and the form to:

Swavek Lorenc, 2458 Adamsway Dr. Aurora, IL 60502.