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Northern Virginia Table Tennis Club
Last Name: First Name: Street Address: City: State: Zip: Arlington County Resident?Fairfax County Resident? Home Phone:() Cell/Mobile Phone#: () Email Address: Date of Birth: // Gender: MaleFemale USATT Membership Id: Expiration: Ranking: Playing level: Novice Intermediate Advanced
You will also need to print out and sign Madison Community Center's Hold Harmless Agreement
This page last updated: Wednesday March 21, 2007