Buckinghamshire County Table Tennis Association
Buckinghamshire County Table Tennis Association
Closed Championship 2014-2015
To be held on Sunday February 1st 2015 at Cippenham Table Tennis Centre
The Westgate School
Cippenham Lane
Slough
Berkshire
Sl1 5AH
Entry Form
Men’s, Women’s and Veteran’s
Name:
Address:
Tel No:
Bucks
League:
* The one in which you play and wish to be shown in the draw as your league.
Events Entered
Tick events required and enter fees payable
(doubles fees are per person)
Singles: Men’s Women’s @£5 ……………
Doubles: Men’s Women’s @£3 ……………
Partner:…………………………………
Mixed Doubles: @£3 ……………
Partner:…………………………………
Veteran’s Singles: Men’s Women’s @£5 ……………
Veteran’s Intermixed Doubles: @£3 ……………
Partner:…………………………………
60+ Intermixed Singles: @5
Total: ……………
Cheques payable to Buckinghamshire County Table Tennis Association
Have you completed the Second page of this form???
Entries must arrive by Sunday 25th January 2015
Please Note That The Losers In the Men, & Veteran’s Singles Get Another Game
Eligibility Declaration
Entry cannot be accepted unless this section is completed and signed (Regulation 1)
Tick the qualification you are using to enter the championships and complete as necessary (One Box Only):
Residence in Bucks*
BIRTH in Bucks*: Born at …………………………………………...
SIX MATCHES for Bucks County Team
*Includes Slough
Date of Birth (if entering Veteran or 60+ events):……………………
Latest date of birth: Veteran – 1 January 1975;
60+ - 1st January 1960
a) I am a member of Buckingham Count T.T.A eligible to play for Buckinghamshire under Regulation 1 (see regulations).
b) I agree to be registered for Buckinghamshire in the County Championships.
c) I have not played for any other County this season.
And I undertake to observe the regulations of the tournament including E.T.T.A Regulation R imposing a ban on the use of liquid adhesives, to abide by the Decisions of the Referee and to fulfil the playing schedule.
Signed: …………………………………………………………………………...
Please return all Entries to:
Mr T Greenham
22 Irvine Drive
Stoke Mandeville
Bucks
HP22 5UN
Telephone: Home 01296 613644 Mobile: 07596001340