Section 1:Player 1 (Delete As Applicable)

Regional Qualifier, where the top team will receive an all expenses paid trip to the National Finals!

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.

Section 1:Player 1 (Delete as applicable)

Player 2 (Delete as applicable)

Section 2: Entry Fee

The entry feeis £10per person.

This is a pair’s event, though individual entries will be accepted.

All cheques should be made payable to “CSSC South West” and should accompany the entry form. Pleasedo not send cash. CSSC is happy to accept one cheque for the full team cost or individual cheques from each team member.If you would like to make a credit/debit card payment, please contact 01494 888407.

WITHDRAWALS:

No refund will be given after the closing date of each competition. Written confirmation to Rebecca Brand must be given of any withdrawals (email is acceptable). If the event is cancelled by CSSC then a refund will be given by the Head Office Treasurer.

Section 3:Competitor Requirements

The competition is open to Civil Servants, Post Office, BT and other affiliated bodies provided that they are full 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.

South West

Section 4: Regional Subsidy for travel and subsistence

CSSC will provide competitors with financial help to attend CSSC Regional Events, please click hereto see what you are entitled to claim or contact the Events team . 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). Please click here for current mileage rates

• 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.

Section 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)

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.

Any enquires directly linked to the event please contactJeff Griffin on e-mail

Signed: Date:

Please send all entries and cheques to:

Post: Rebecca Brand

CSSC Sports & Leisure

Compton Court

20-24 Temple End

High Wycombe

Bucks, HP13 5DR Contact:one: 01494 888407