• Tidak ada hasil yang ditemukan

Note: All fields marked * are mandatory and must be completed to confirm the entry. Entrant Details

N/A
N/A
Protected

Academic year: 2024

Membagikan "Note: All fields marked * are mandatory and must be completed to confirm the entry. Entrant Details"

Copied!
1
0
0

Teks penuh

(1)

Note: All fields marked * are mandatory and must be completed to confirm the entry.

Entrant Details

Discipline* ☐ Men’s Pairs ☐ Women’s Pairs Skips Details

First Name* Surname*

E-mail*

Contact Number* Club*

Team Details

Lead*

Payment Details

Cheques should be made out to Bowls Tasmania.

Direct Debit can be made to; BSB Number: 633-000 Account Number: 130805310 If paying by credit card, please complete the below details.

Name on Card

Card Type ☐ MASTERCARD ☐ VISA

Card Number

Expiry Date CSV Signature

Waiver

Paper Entries close at 5pm Friday 14th December 2018. Any entries received after this date will not be accepted. Cost of entry is inclusive of match fees and entry into the Satellite Series should you wish to participate. Entry is not complete unless accompanied with full payment and all mandatory fields are completed. Bowls Tasmania will email written confirmation once entries are confirmed.

I confirm that I am eligible to participate in the event as per the Conditions of Play and agree that all information provided is true and accurate and will be used by the event management for the purposes of the Gala Week related activities.

Signed* Date

If under 18, a parent or guardian must complete the below details.

First & Last Name Signature

Submitting your entry

Post: Email:

Bowls Tasmania Att. Gala Week

PO Box 4041 Bowls Tasmania

Invermay TAS 7248 [email protected]

Referensi

Dokumen terkait