Northwest Washington Open entry form

Please print out, complete and sign this form. Include a check payable to Jim Hornbacher, Tournament Director, and mail to:

Jim Hornbacher
Northwest Washington Open
22811 Lakeview Drive F-309
Mountlake Terrace, WA 98043

Name	______________________________________________
Address	______________________________________________
City, State, Zip	______________________________________________
Telephone	__________________	Email	____________________
ACC member number (if applicable):		__________________

	$10/$5 Q	Early Bird
	$25	Doubles (Partner name __________________ )
	$50/$50 Q	High Rollers
	$60 ($70 non-ACC members)	Main Event
	$10 Q	Main Event
	$20/$10 Q	Saturday Night Special
	___________________	TOTAL AMOUNT ENCLOSED

	Check here to request handicapped seating

I agree to abide by the rules of the American Cribbage Congress and by the rules set by the tournament director.

__________________________________________
SIGNATURE

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2002 Northwest Washington Open entry form