REGISTRATION FORM
www.wernvalley.com
2010 “MILLER LITE SPORTING CLAYS CHAMPIONSHIP” JUNE 11 – 13, 2010
SQUADDING – Circle one
Flight #1 9 AM Sat. & 1 PM Sun.
Flight #2 1 PM Sat. & 9 AM Sun.
Print your name first, then 4 others.
1.______
2.______
3.______
4.______
5.______
Squadding will be confirmed ONLY after full payment from all team members is received.
Squad Questions call the Club (262) 968-2400. Tuesday – Saturdays
. Sunday & Mondays - Closed
Make checks payable to:
WERN VALLEY SPORTSMENS CLUB
S36W29657 Wern Way
Waukesha, WI 53189
Fax: (262) 968-3455
Office: (262) 968-2400
Credit Cards Accepted
Visa, MC, or Discover
Credit Card Number:
______
______
Exp. Date_____/______
V Code______(last 3 numbers on back of card)
Sign______/ NSCA # CLASS
CONCURRENT LDY SJ JR VT SVT SSV (Please Circle) /
NAME
ADDRESS
CITY STATE ZIP
DAY PHONE
KOLAR ARMS SMALL GA. CHAMPIONSHIP
$1,000.00 Added money – Event 1,2,& 3
$100.00 HOA - $300.00 Added per gauge – split equal
3 lewis classes (all ties shoot off)
FRIDAY / JUNE 11
Event #1 50 Bird 410 Event $40.00 (includes fees & tax)
($5.00 to 3 lewis classes) / $
Lewis Option (3 classes – ties divide) $10.00 / $
Class Purse $ 5.00 / $
Event #2 S & R Compost 100 Bird 12 Ga.
($5.00 to 3 lewis classes) $65.00 (includes fees & tax) / $
Lewis Option (3 classes – ties divide) $10.00 / $
Class Purse $ 5.00 / $
SATURDAY / JUNE 12
Event #3 50 Bird 28 Ga. $40.00 (includes fees & tax)
($5.00 to 3 lewis classes) / $
Lewis Option (3 classes – ties divide) $10.00 / $
Class Purse $ 5.00 / $
SUNDAY / JUNE 13
Event #4 50 Bird 20 Ga. $40.00 (includes fees & tax)
($5.00 to 3 lewis classes) / $
Lewis Option (3 classes – ties divide) $10.00 / $
Class Purse $ 5.00 / $
SATURDAY & SUNDAY / JUNE 12 – JUNE 13
Event #5 FIOCCHI’S 50 Bird 5 – Stand
Choose One: Sat. AM PM or Sun. AM PM (Please circle)
Entry Fee $40.00 (includes fees & tax) / $
Lewis Option (3 classes – ties divide) $10.00 / $
Class Purse (60/40 ties divide) $10.00 / $
SATURDAY & SUNDAY / JUNE 12 – JUNE 13
Event #6 Miller-Lite Sporting Clays Championship
Entry Fee (includes horsd’oeuvres) $169.00 (includes fees & tax) / $
$
High Gun Option (60/40 ties divide) $10.00 / $
Lewis Option (4 classes ties divide) $10.00 / $
Class Purse (60/40 ties divide) $10.00 / $
Lucky Number-First Day’s Score $5.00 (shoot-off on Sunday) / $
Entry Fee Hunter Class $163.00 (includes WSCA fee) / $
E-Z GO GOLF CARTS Saturday & Sunday $100.00
NO FRIDAY ONLY Friday, Saturday & Sunday $145.00
(please circle your choice)
ALL GOLF CARTS MUST BE RESERVED BY MAY 31st, 2010
Only 2 seaters available!!! / $
GRAND TOTAL / $
MINIMUM DEPOSIT REQUIRED / $ 100.00
Balance Due: / $
NO REFUND AFTER MAY 31st , 2010 or once an event starts
Wern Valley Sportsmens Club
S36 W29657 Wern Way
Waukesha, WI 53189
WERN VALLEY SPORTSMENS CLUB
2010 MILLER - LITE
Sporting Clays Championship
June 11th, 12th, & 13th
Guaranteed Cash Payout - Main Event
Champion - $1,000.00 /Master - Class E
4 places each class/$375 - $275 - $175 - $75
(Payouts based on 200 Entries)
www.wernvalley.com or
AREA HOTELS
COUNTRY PRIDE (262) 646-3300 * PREFERRED
LA QUINTA (262) 395-1162 * PREFERRED
COMFORT INN & SUITES (262) 506-2000 *PREFERRED
HOLIDAY INN (262) 646-7077
COUNTRY INN (262) 547-0201
* WHEN CALLING THE PREFERRED INDICATE YOU ARE RESERVING A ROOM FOR THE MILLER-LITE OPEN TO GET THE DISCOUNT!
Wern Valley Sportsmens Club is located 5 minutes west of Waukesha on Wern Way (Hwy D) only 35 minutes from downtown Milwaukee. 10 miles south of the 1-94 Hartland-Wales Hwy 83 exit or 10 minutes north of 1-43 Mukwonago Hwy 83 exit. 1.5 miles east of Hwy 83 on D.
SPONSORS