CSSC Event Entry Form

CSSC Event Entry Form

Sport / Open Team Badminton Tournament
Venue / Wycombe Badminton Centre, Crest Road, High Wycombe HP11 1UA
Date of event / Friday 26 October 2018
Closing date for entries / Monday 1 October 2018

This event is also open to your friends or family members.As a reminder, under theLinked membership scheme, up to three of your friends or family members can join CSSC and take part in our events at the member’s 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.

Please completeall sections in BLOCK CAPITALS. CSSC membership numbers must be included.

Teams must comprise of two men and two ladies – if you are not part of a full team please let us know as there may be others in a similar position that we can match you up with.

Section 1: Captains Details / Team Member 1

Department/Organisation______Team Name: ______

Mr/Mrs/Miss/Ms/Other / Forename: / Surname:
Male/Female / Date of birth:
Home 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.

Player 2

Mr/Mrs/Miss/Ms/Other / Forename: / Surname:
Male/Female / Date of birth:
Home 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.

Player 3

Mr/Mrs/Miss/Ms/Other / Forename: / Surname:
Male/Female / Date of birth:
Home 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.

Player 4

Mr/Mrs/Miss/Ms/Other / Forename: / Surname:
Male/Female / Date of birth:
Home 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 for this event is £15.00 per team.

Payment Method: Credit/Debit Card BACS Cheque

Payment can be made by credit/debit card – please phone Hilary on 01494 888438 to use this facility.

Paying by BACS: HSBC, Sort Code: 40-02-06, Account Number: 50232572. Please quote TEAMBAD16followed by team name as a BACS reference.

Cheques should be made payable to CSSC Ltd.

Section 3: National Travel Policy

All CSSC Regions have signed up to provide competitors with financial help to attend CSSC Regional and National Open Events, please click here to see what you are entitled to claim or email the CSSC Events team on .

All claims must be made within3 months of the competition and receipts must be provided where applicable.

Section 4: Sport Specific Information

Level of Play:

Casual / Club / League / County

Section 5: Medical and Dietary Requirements

Medical: please let us know if you have any physical or medical conditions, that
might effect your attendance
. / Yes No
If yes, please give details
Dietary: please let us know if you have any special dietary requirements. / Yes No
If yes, please give details

Signed: Date:

Please send all entries to:

Name:Hilary Gray

Email:

Post:CSSC Sports and Leisure

Compton Court

20-24 Temple End

High Wycombe

Bucks

HP13 5DR

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.

Office use only:

Date entry received: