Event / Mixed Team Golf Competition 2017
Venue / The Warwickshire Golf Club, Warwick, CV35 7QT
Date of event / 16/17 March 2017
Closing date for entries / 17 February2017

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.

Team Name:

1. Team Member 1Details (Delete as applicable)

Title: / Forename: / Surname:
Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Handicap
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.

Team Member 2 (Delete as applicable)

Title: / Forename: / Surname:
Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Handicap
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.

Team Member 3 (Delete as applicable)

Title: / Forename: / Surname:
Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Handicap
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.

Team Member 4 (Delete as applicable)

Title: / Forename: / Surname:
Gender: / Over 18: / Yes / No
Home Address
Postcode
CSSC membership no.
Handicap
Home Telephone no. / Work Telephone no.
Mobile Telephone no. / Email
Next of Kin / NoK Contact Tel. no.

2. Entry Fee

The entry fee is £115per person.

To pay by Credit / Debit card please call 01494 888439

All cheques should be made payable to CSSC Ltdand 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.

Total amount enclosed: / £ / Method of Payment

3. Event Information

The Mixed Team Golf competition will comprise teams of 4 of any make up (i.e. 4 ladies, 4 men or 2 men and 2 ladies etc). There will be two rounds of Golf played on the Kings and Earls courses. On day 1 play will commence at 12.00 on day 2 play will start at 9.00. Overnight accommodation (twin rooms – Thursday 16th only), use of the leisure and spa facilities, 3 course evening meal and breakfast are also included in the price. The format of the competition will be Stableford betterball for the two rounds, with different prizes on offer. Handicap limits of 28 for the men and 36 for ladies.

Please note that places are limited and will be given on a first come first served basis.

If you do not have a team of 4 every effort will be made to accommodate single entries as well as pairs.

National Subsidy for travel and subsistence

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

Costs for use of a private car are assessed on the basis of mileage and fuel type and will be as follows:

  • Driver - 50% of mileage costs up to one times the current full annual CSSC subscription;
  • 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 times the current full annual CSSC subscription;
  • For each night only50% of the cost up to a maximum of the current full annual CSSC subscription; subject to a maximum claim for any one event of two times the current full annual CSSC subscription.

4. 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 details
Any 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 organiser’s decision on all matters is final. All entries to be received by 17/02/2017.Any enquires directly linked to the event please contact Matthew Taylor on 01494 888439 or e-mail

Signed: Date:

Please send all entries and cheques to:

Post: Matthew Taylor

CSSC Sports & Leisure

Compton Court

20-24 Temple End

High Wycombe

Bucks

HP13 5DR