Master Teams
Entry Form
WESTERN BCA POOL PLAYERS ASSOCIATION
Master Team Play begins Saturday, Mar. 17, 2012. See event schedule or online brackets for each division's start time. All times/matches online are subject to change without notice. Team Registration at podium by Captain is required prior to the start of team play. 17th Annual Regional 8-Ball Championships
March 12-18, 2012
Chinook Winds Casino Resort - Lincoln City, Oregon
If possible, please fill out this form before printing. If you cannot please print clearly. Incomplete, inaccurate or illegible forms will delay processing and may be returned.
Team Name: Captain's email/phone:
Players (Subs can be added at Team Registration) CW Winners Circle
Card #
Gender Player's Rating
(Only 1 GM/team, Open players OK)
Junior (16-20) If yes: Birthdate
C: M F Master GM Open
2: M F Master GM Open
3: M F Master GM Open
4: M F Master GM Open
5: M F Master GM Open
Any player with a medical exemption to the Dress Code must submit a physician's letter with entry form unless one is already on file.
Division Race Entry Fee Green Fee Total Fee

Mens/Mixed Master Team (5-Person)

13 $250 $65 $315
Womens Master Team (4-Person, women only) 13 $200 $60 $260

By entering your Chinook Winds Winners Circle Card number(s) on this form you MAY be 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 fees include table time for this tournament event, 2nd chance tournaments, ring games, mini-tournaments and practice.

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 February 6, 2012. Late entries must be postmarked by February 13 and include non-refundable late fee of $10. No exceptions. Service charge for returned checks: $25.00.

By signing below, I, the above named team captain, stipulate that I and my players are Western BCA players in good standing, have paid our membership fees for the current year, have met the eligibility requirements for entry into this tournament and are entering in our proper division. Any Juniors have filled in their birthdate. My signature further indicates our agreement that our names and likenesses 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 entrant's League Operator will invalidate this entry. Send form + fee by date specified by the Tournament Registrar.
Signed:________________________________________________________Date:____________