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The Somerset Open Shoot - 28th April 2019 - Entry Form

Competitor's Details

Fields marked * are essential

First Name *

Surname *

Street Address

Town

County *

Post Code

Telephone *

Email *

Confirm Email *

Club *

NSRA No.*

Average

Class Entered *

If no average is given, class X will be allocated. The Committee reserves the right to re-classify competitors.

If you are left handed please check the box: -

DATA PROTECTION NOTICE.
The SSBSA will store the information provided on this entry form on a secure computer for the purposes of the administration of the competition, distribution of results & notification of future events. Forms will be retained for a period of up to six years after the competition. Results will be retained indefinitely for the purposes of future reference & maintaining historical records, and as such may be distributed to interested parties.
It is a condition of entry that competitors agree to their surname & initials, club & scores appearing in the results of the meeting, however these results may be published, including on the SSBSA website. The SSBSA will not use any competitor’s data for commercial purposes nor give permission for such use to a third party.

DECLARATION - Please read the following statements & check the boxes to confirm your agreement: -

I confirm that the above details & my declared average are correct & have been verified by my Club Captain/Secretary/Stats Officer: - *
I confirm that I have read, accept, and agree to abide by the Competition Rules: - *
I consent to my personal details being used as indicated above:-*

Squad required:

1st Choice *

2nd Choice

3rd Choice

Entries will be squadded strictly in order of receipt. Cross squadding is not permitted.

Competition Entry

Insert the fee(s) in the Totals column to indicate
which competition(s) you are entering

Entry Fee

Totals

Aggregate (Excluding juniors)

£15.00

£

Junior Championship (Including aggregate)(Age under 21 on 31st December next)

£7.50

£

Open Ladies Championship

£3.00

£

Veterans (Age 60 or over on 31st December next)

£3.00

£

Pairs (£3.00 each / £6.00 per pair) Partner's name

£3.00/£6.00

£

Open Team Championship - Club team of 4 (Price is for the team)
Club name Please list your fellow team members' names below.

£6.00

£

Inter Club Team Handicap Competition - SSBSA Affiliated Clubs Team of 4 (Price is for the team)
Club Name Please list your fellow team members' names below.

£6.00

£

Somerset SuperDraw (Delete if not required)

£1.00

£

NB: Your fee will be collected on your arrival at the range

Total Due

£

If you have entered a team of 4 for the Open Team Championship
please list your 3 fellow team members here: -
(NB: All team members must be from the same Club & have entered the aggregate competition)

If you have entered a team of 4 for the IC Handicap Team Championship
please list your 3 fellow team members here:-
NB All team members must be from the same SSBSA affiliated club & have entered the aggregate competition)

Additional information

And finally ... To help stop automated spam messages, please answer this question: -

What is the name of the city closest to Long Ashton? *