All mail in registrations must be received on or before 3:00pm Friday, June 14th, 2013.

NAME
______________________________________________________________________
ADDRESS
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CITY
______________________________________________________________________
STATE
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ZIP/CODE
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DATE OF BIRTH
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PHONE NUMBER
______________________________________________________________________
PLAYER REWARDS CLUB #
______________________________________________________________________
E-MAIL ADDRESS:
______________________________________________________________________
NUMBER OF ENTRIES
One | Two
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Would you like to reserve a Tiny Tim in the racebook? Circle one.
NO  |  YES


I HAVE READ, UNDERSTAND AND AGREE to abide by all Handicapping Tournament rules and regulations. In the event of a dispute, the Handicapping Tournament Judge will render a decision. The decision of the Judge is final. The Judge has the right to disqualify any tournament entrant who has violated any of the rules and regulations and the entrant will forfeit their registration fee.

In consideration of my participation in the tournament, I do hereby irrevocably authorize Delaware Park or their licensees to print, publish, televise or otherwise distribute and use my name, wagering information, photographs or likeness. I declare that I am over 21 years of age and I am not an employee of Delaware Park company, Coast Casino's and Boyd Gaming their immediate families, or any affiliated companies.

SIGNATURE
__________________________________________________
DATE
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