Please Put Me On A Team

Y

(Players cannot receive prizes without SS# on file and cannot receive an age related prize without birth date on file)

(Mr.) (Ms.) First Name *

Middle:

Last Name *

Gender

M

F

Email Address

USBC Card #

Home Phone

Work or Cell

Street Address *

City *

State *

Zip Code *

Date of Birth +

SSN#

Recruited by:

Ever receive an average rerate/reassignment?

Yes (received Avg. Rerate/Assignment)

No (have not received Avg. Rerate/Assignment)

Send a confirmation to everyone on the team?

Y (send confirmation)

N (no confirmation)

I have a U.S. Military background and receive a $25 discount on my $200 entry

Yes (U.S. Military Background discount)

PARTICIPANT'S AGREEMENT: I have read and agree to abide by the rules and regulations of the 2019 Columbus Day Seniors Team Classic. *

I AGREE

For Team Captains

Team Name:

Team Captain:

Your squad choice:

2nd choice:

List your lineup below. It will be the same for Team, Doubles & Singles. Doubles teams are bowlers 1 & 2 and bowlers 3 & 4. See rules in brochure.

Bowler 1

Bowler 2

Bowler 3

Bowler 4

2019 Columbus Day Seniors Team Entry Fee

Bowl 3 events – Team, Doubles & Singles
$200 per person – $225 onsite
(Entry fee includes Sidepots for Team, Doubles & Singles events)

Entry Fee $200

2019 Columbus Day Seniors Team Entry

Military Discount -$25

WANT MORE BOWLING?

Additional Events

Optional All-Events $20	Handicap 3-game Sweeper Mon, 5 PM – $40	Handicap 3-game Sweeper Wed, 5 PM – $40
Scratch 3-game Sweeper Mon, 5 PM – $40	Scratch 3-game Sweeper Wed, 5 PM – $40	Handicap No Tap Tues, 7 PM – $40
Handicap No Tap Thurs, 7 PM – $40	Mixed Doubles Tues 5 PM $20 (per person)	Mixed Doubles Thurs, 5 PM $20 (per person)

PAYMENT INFORMATION – Add 5% to total for credit card use.

Name on Card

Bill amount:

Credit Card Type

CREDIT CARD NUMBER: Please use dashes instead of spaces.

Ex. Date (mm/yy)

CVV:

Enter the word in the image *
captcha

5% Added to your order for Credit Card Use

0.00

SPECIAL INSTRUCTIONS: Please list any special instructions below. List your 2 alternate squad choices in the box. Also where are you staying in Las Vegas?