Venue / 147 Sports Bar, Pudsey, Leeds LS28 7RZ
Date of event / Friday 23 March 2018 – Registration from 10.30 for 11.00 start
Closing date for entries / Friday 16 March 2018
Winner of this event will be invited to represent the Yorkshire Region at the CSSC National Pool Finals 2018- all expenses paid (providing the qualifying criteria is met)
Please completeall sections in BLOCK CAPITALS. CSSC membership numbers must be included.You may find it helpful to‘Tab’ from one field to another.
Section 1: Details
Player One
Title: / Forename: / Surname:Gender: / Over 18: / Yes / No
Address (for communication)
Postcode
CSSC membership No.:
Staff / Payroll Number:
Home Telephone No.: / Work Telephone No.
Fax No.: / Email
Next of Kin / NoK Contact Tel. no.
Section 2: Entry Fee
The entry fee is £5.00 per person.
Payment can be made by debit/credit card – just ring Hilary Gray on 01494 888438
All cheques should be made payable to“CSSC Yorkshire”and should accompany the entry form. Please do not send cash
Total amount: / £ / Payment method:Section 3: Travel Subsidy
CSSC has a policy of helping competitors with the expense of attending Regional and National Open Finals. The expenses relate to travelling costs and accommodation (where necessary).
The claims will be checked and where all the criteria are satisfied, paid out by the Event Team at CSSC Head Office. The full terms & conditions and claim form can be found on the CSSC Website
Section 4: Competitor Requirements
The competition is open to all full subscribing members of CSSC.
This event is open to your friends or family members.As a reminder under our new Linked membership scheme, up to three of your friends or family members can join CSSC and take part in our events at a members’ rate. Membership is also available to staff working in the Public Sector such as NHS, local government, teachers, the police, fire fighters and HM Armed forces personnel.
If you do not know your CSSC number please contact our membership department on 01494 888443.
If you require a form to sign up a new member please contact Hilary on 01494 888438 or
Section 5: Important Information
This event is played to Blackball Rules.
Medical: Please let us know if you have any physical or medical conditions
Yes/No (Delete as applicable)
If yes, please give detailsIMPORTANT: 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 organisers decision on all matters is final. All entries to be received byHilary Gray
Once entry forms and payments are received an acknowledgement will be sent out by email.
Any enquires directly linked to the event please contactPaul Buck on
or 03000 513932(Work).
Signed: Date:
Please send all entries and cheques to:
Post: Hilary Gray
CSSC Sports & Leisure
Compton Court
20-24 Temple End
High Wycombe
Bucks
HP13 5DR
Contact:
01494 888438