Stellan Camp Registration Form for

($500 for one session or $1,000 for both)
Please be accurate. This is important.     

At the Willamette Table Tennis Club
1960 Oak St. SE, Salem, Oregon

Capacity is limited and prepayment is required.
Fee: $500/session

Make your check payable to:
xxxxWillamette Table Tennis Club
and mail to:
xxxxxxxc/o Ben Bednarz
xxxxxxx780 Commercial St. SE
xxxxxxxSuite 300
xxxxxxxSalem, OR 97301

Special discount for those over 1900
First time participants only: rated over 1900, take off $50
from your fee.

Questions? Contact Ben Bednarz at
xxxxxxxcell: 503-851-2941