SINGLES Entry Form
WESTERN BCA POOL PLAYERS ASSOCIATION
13th Annual Regional 9-Ball Championships
Singles begin: Wednesday, October 13, 2010, 1pm. See event schedule or online brackets for each divisions start time. All times and matches online are subject to change without notice.
Chinook Winds Winners Circle Card Number
Player Information Gender Division Race Entry Fee Green Fee Total Fee Fee Paid
Name: 8 $50 $25 $75

 
Phone: Open-A 7 $40 $25 $65
Email: Open-B 6 $30 $20 $50
Senior 6 $35 $20 $55
If Yes, my Birthdate is: Novice 5 $15 $15 $30
I am entering Senior Singles 8 $50 $25 $75
If yes, my Birthdate is: Open 6 $35 $20 $55
  Senior 6 $35 $20 $55
  Novice 5 $15 $15 $30
By entering your Chinook Winds Winners Circle Card number on this form you are automatically entered into a drawing for cash prizes of $250, $150 and $100 sponsored by Chinook Winds Casino Resort. You can only be entered into this drawing by including your winners circle number on an official entry form. One entry per person (not per event entered) will be submitted for this drawing.
Green fee covers table time for Singles play, 2nd chance tournaments, mini-tournaments, ring games and practice.
Please note that the Novice division is trophy only, no cash prizes will be given but winner will receive paid entry into next open event.
Entries must be submitted through your League Operator. Make checks payable to Western BCA. All fees must accompany this form. Your cancelled check is your receipt. Entries must be postmarked or in the hands of your League Operator no later than September 7, 2010. Late entries must be postmarked by September 14 and include
non-refundable late fees of $10. No exceptions. Service charge for returned checks: $25.00.
By signing below, I, the above named entrant, stipulate that I am a Western BCA player in good standing, have paid my membership fees for the current year, have met the eligibility requirements for entry into this tournament and am entering in my proper division. If I am a junior or entering Senior Singles, my birthdate is filled in. My signature further indicates my agreement that my name and likeness may be reproduced for publication on the Western BCA website and in any media outlet with which Western BCA contracts for informational and promotional purposes. False information will result in immediate expulsion from the tournament and forfeiture of all fees.
Signed: _____________________________________________________Date: ___________
League Operator: Review and verify entrant's information and eligibility. Must be signed. Signature below by anyone other than the entrants' League Operator(s) (both if masters not from the same league) will invalidate this entry. Send form and fee by date specified by the Tournament Registrar.
Signed:_____________________________________________________Date:____________