| Your name: | ______________________________ |
| Your grade | ______________________________ |
| Your club, if any | ______________________________ |
| Are you a concession? | ______________________________ |
| Would you like to be hidden on the public registration list? |
______________________________ |
| Your email address | ______________________________ |
Mail this form to:
Go Tournament
David Buckley
27 Crosbie Road
Coventry
CV5 8FX