Venue / City and County of Swansea Indoor Bowls Club – SA6 8HR
Date of event / Sunday 20 November 2016
Closing date for entries / Friday 11 November 2016
This event is a regional qualifying competition and the winner will be invited to represent the Welsh Region at the CSSC Indoor Bowls National finals in April in York – all expenses paid (providing the qualifying criteria is met).
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.
Department/OrganisationSection 1: YourDetails (Delete as applicable)
Mr/Mrs/Miss/Ms/Other / Forename: / Surname:Male/Female / Date of birth:
Address
Postcode
CSSC membership no.
Staff / Payroll Number.
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 £3.00 per bowler
Payment can be made by credit/debit card please ring Hilary Gray on 01494 888438 with details
All cheques to be made payable to Wales CSSC and should accompany the entry form. Please do not send cash
Amount Paid: / Payment method:This event is open to your friends or family members. As a reminder, under our Linked membership scheme, up to three of your friends or family members can join CSSC and take part in our events at 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.
Section 3: Information
All competitors must be subscribing members of CSSC
Registration time: 9:30am
Start time: 10.00am
Section 4: Regional Subsidy for travel and subsistence
The Wales 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 Robert Garrington via email . All claims must be made within3 months of the competition and receipts must be provided where applicable.
Section 5: Medical and Dietary Requirements
Medical: please let us know if you have any physical or medical conditions. / Yes NoIf yes, please give details
Dietary: please let us know if you have any special dietary requirements. / Yes No
If yes, please give details
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.
If you require any further information concerning this event please contact David L. Davies on 07812 500393, email
The organisers reserve the right to cancel this event if there are insufficient entries by the closing date.
Signed: Date:
Please send all entries to:
Post:Hilary Gray - Event Team
Compton Court,
20-24 Temple End,
High Wycombe
Bucks HP13 5DR
Email:
Tel: 01494 888438 Fax: 01494 888437