Venue / Risby Gate Indoor Bowls Centre, Westly Road, Bury St Edmunds, Suffolk
Date of event / Saturday 4 February 2017 – Registration 09.30 for 10.00 start
Closing date for entries / Friday 6 January 2017
Regional Qualifier, where the winners will receive an all expenses paid trip to the national finals (providing the qualifying criteria is met). Open to all subscribing members of CSSC.
Entries from individual bowlers for teaming up into pairs are welcome. Please contact the organiser as there may be others in a similar position
Please complete all sections in BLOCK CAPITALS. CSSC membership number must be included. You may find it helpful to‘Tab’ from one field to another.
Team Name:- Details (Delete as applicable)
Title: / Forename: / Surname:
Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Staff/Payroll No:
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.
Team member 2 - Details (Delete as applicable)
Title: / Forename: / Surname:Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Staff/Payroll No:
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.
- Entry Fee
The entry fee is£18.00 per person, £36.00 per pair. A buffet lunch will be included plus tea and cake during the afternoon.
Payment can be made by credit/debit card - please ring Hilary Gray on 01494 888438 with details.
All cheques should be made payable to “CSSC Eastern” and should accompany the entry form. Pleasedo not send cash.
Total amount / £ / Payment method:3. Competitor Requirements
The competition is open to all subscribingmembers of CSSC.
Anyone who is not a subscribing member of CSSC and wishes to take part must obtain a membership application form. If you are unable to quote your membership number please contact CSSC Head Office on 01494 888444.
This event is also 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.
- Regional Subsidy for travel and subsistence
The Eastern Region have signed up to provide competitors with financial help to attend CSSC Regional Events, please click hereto 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.
- Costs for use of a private car are assessed on the basis of mileage and fuel type and will be rebated as follows: Driver - 50% of mileage costs up to one half the current full annual CSSC subscription (£45.60). Claim forms will contain current mileage rates at time of completion, please note these rates are subject to change.
- Passengers – 5p per mile up to a maximum of £15 per passenger.
- Costs for use of public transport will be 50% of costs up to one half the current full annual CSSC subscription;
If the event requires you to make a round trip exceeding 200 miles you are eligible to stay overnight in the vicinity of the event. The cost of that accommodation will be as follows:
- for each night only50% of the cost up to a maximum of the current full annual CSSC subscription; subject to a maximum for any one event of two times the current full annual CSSC subscription.
5. Important Information
Medical: Please let us know if any member of your team has any physical or medical conditions
Yes/No (Delete as applicable)
If yes, please give detailsAny 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 organisers decision on all matters is final. All entries to be received by Hilary Gray
Any enquires directly linked to the event please contact Joy Kent on 01487 841371 or 07980 118726, email
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
Telephone: 01494 888438
Email:
Photocopied forms are also acceptable.
Date received: ………………………………………………. Acknowledgement sent: ………………………………..