JUNIOR IRISH OPEN CHAMPIONSHIPS

LEISUREPLEX

STILLORGAN

5th to 7th NOVEMBER 2010

 

OFFICIAL ENTRY FORM

 

Firstname……………………………………..Surname………………………………….

 

 

Male / Female………………………………Nationality………...………………………………………

 

 

Address..(1)……………………………………………………………………………………………….

 

 

Address..(2)……………………………………………………….……………………………………….

 

  

Telephone (Day)……………………………………….(Evening)…………………………………….

 

 

Date of Birth……………………………………………Age…………………………………………….

 

 

Entry Authorised by…………………………………………..………………………………………….

(National Association Official / Bowling Centre Manager)

 

Preferred Squad : Friday 19.30pm…………………………  

 

Saturday 08.30am……………………..    Sat 10.0am………………………… ..

 

Saturday 11.30am……………………..   ( Under 12’s )

 

Please Indicate your age Group: 

 

Boys Under 12…..……… Girls Under 12……….……….Boys Under 16………………

 

Girls Under 16…..……….Boys Under 19………………..Girls Under 19……………….. Under 23…………………

 

Cheques should be made payable to Leisureplex and forwarded with the above completed form to :

Mr Sean Kennedy.   Leisureplex Stillorgan, Old Bray Road, Co. Dublin.

On or before 3rd November 2010.

Queries regarding the tournament you should Contact Sean Kennedy or Lorraine Mayland at 353-1-2881656,

Fax 353-1-2885246, Email :- stillorgan@leisureplex.ie, or Sean Kennedy on mobile at 353-86-8248222, or sean@leisureplex.ie

The Bowlers Pro Shop – Contact Barry at 086-267-3955

ENTRY FEES

16’S, 19’S, 23’S Divisions €45.00; 12’s €25.00

Includes Linage & Junior ITBA Fund