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2005 March Madness Registration Form March 11-13, 2005 -- Santa Barbara Athletic Club Contact: Robert Graham sbbolox@aol.com Name: Street Address: City State Zip: Primary Phone: Secondary Phone: Email Address: Credit Card Type: Visa MC AMEX Name On Card: Card Number: Expiration Month: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Expiration Year: 2005 2006 2007 2008 2009 2010 Skill Level: 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 Pro USSRA Number: Birthday (mm/dd/yyyy): Special Constraints: I hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against Santa Barbara Athletic Club, Inc. and their respective representatives for any and all injuries suffered by me in connection with this tournament.

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