Event

Event / North West Snooker Tournament 2017
Venue / Rileys Sports Bar,Liverpool Grand Central, Bolton Street, Liverpool, L3 5LX
Date of event / Friday 14 July 2017
Closing date for entries / Friday 7July 2017

Please complete all sections in BLOCK CAPITALS. CSSC membership numbers must be included. You may find it helpful to ‘Tab’ from one field to another.

Title: / Forename: / Surname:
Gender:
Home Address
Postcode
CSSC membership no.
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.

Section 2: Entry Fee

The entry fee is £10.00 per person. Refundable upon participation via the National Travel Policy. Cheques will be kept and shredded once confirmation of attendance.

To pay by card please call Jennifer on 01494 888434quoting thename and date of event as above.

All chequesshould be made payable to ‘CSSC North West’ and should accompany the entry form. Please do not send cash.

Total payment amount: / £ / Payment method:

Section 3: National Travel Policy- Subsidy for travel and subsistence

The North West Region have signed up to provide competitors with financial help to attend CSSC Regional Events, please click here to see what you are entitled to claim or contact the CSSC Events team via email . All claims must be made within3 months of the competition and receipts must be provided where applicable.

Section 4: Competition

This competition is open to all subscribing members of CSSC.

The competition will start at 12.30pm. Registration at 12:00pm

Spectators Welcome

Section 5: Important Information

Medical: Please let us know if you have any physical or medical conditions

Yes/No (Delete as applicable)

If yes, please give details
Any Dietary Requirements

IMPORTANT: These events are active and players should be aware of the physical activities involved. CSSC reserves the right to cancel the event if under subscribed.

All CSSC members taking part in the event are covered by CSSC Sports and Leisure Public Liability Insurance. Please note that this policy is NOT a Personal Accident Policy. Members are encouraged to take out their own insurance policy.

The organiser reserves the right to cancel any event if there are insufficient entries. The organiser’s decision on all matters is final. All entries to be received byFriday 7 July 2017.

Any enquires directly linked to the event please contact Tony Southernon 07736551771 (mobile)/ 0151 2895942 (Home) or e-mail

Signed: Date:

Please send all entries to:

Email:

Post: Jennifer Yarrow

CSSC Sports & Leisure

Compton Court

20-24 Temple End

High Wycombe

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