World Series of Poker

2005 World Series of Poker Tournament Pre-Registration Information and Deposit

Last Name
First Name
Initial
Date of Birth
Street Address
City
State
Zip Code
Country
E-Mail Address
Phone number
Event Date
Event #
Event Description
Total Buy - In Amount

Form of Deposit	Please check one
Cashiers Check
Wire Transfer

This pre-registration form must be sent with your check or wire transfer deposit to:

Rio Suite Hotel and Casino
World Series of Poker
Attention: Accounting Office
P O Box 14160
Las Vegas, Nevada 89114-4160
Or Fax to: 702-777-7957

I understand that my ability to participate in the Tournament is conditioned upon my compliance with the Tournament General Rules and that one must appear in person to finalize the registration process . By signing this statement, I further understand that, once submitted, my deposit is non-refundable, except and unless determined so by Harrah's acting in its sole and absolute discretion.

Signature: