Venue / Cheltenham Bowling Club, Suffolk Square GL50 3DX
Date of event / Friday 11August 2017
Closing date for entries / Friday 28July 2017
This event is open to your friends or family members. As a reminder, under our Linked membership scheme, up to three of your friends or family members can join CSSC and take part in our events at 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.
Team will consist of four players (a substitute 5th player is permitted)
Please completeall sections in BLOCK CAPITALS. CSSC membership numbers must be included.
Section 1: Captains Details
Department: ______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.
Section 2:Team Details
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.
Player 5
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 3: Entry fee
The entry fee for this event is £4 per player - £16 per team of 4 - £20 per team of 5. This includes morning tea and coffee plus a filled bread roll and slice of cake at lunchtime.
Payment Method: Credit/Debit Card Cheque
Payment can be made by credit/debit card – please phone Hilary on 01494 888438 to use this facility.
Cheques should be made payable to CSSC Ltd.
Section 4: Accommodation
The Holiday Inn, Gloucester is happy to offer CSSC members a special rate for B & B for this tournament.
Please quote CSSC Open Bowls when contacting the hotel to obtain this preferential rate. Teams will be required to pay the hotel direct for any bookings they may make.
Section 5: Medical and Dietary Requirements
Medical: please let us know if you have any physical or medical conditions, that mighteffect 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
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.
Signed: Date:
Please send all entries to:
Name:Hilary Gray
Email:
Post:CSSC Sports and Leisure
Compton Court
20-24 Temple End
High Wycombe
BucksHP13 5DR
Telephone: 01494 888438