Tournament Entry Form
ADVERTISEMENT
1
228TH ANNUAL GEORGIA 500 CLUB
SINGLES TOURNAMENT
USBC SANCTIONED HANDICAP TOURNAMENT
September 16-17, 2017
WALK-IN TOURNAMENT
ADVANCED RESERVATIONS REQUESTED &
PREFERRED
(Entries accepted up to 1 hour prior to start of session)
Langston-Gray Bowling Center
1812 E. Shotwell Street, Bainbridge, GA 39819
229-246-5530
Meeting: 10:00 AM - 9/17/17
Cost is $34.00 per entry
Sessions: 4 PM - 9/16/17 and
May enter both sessions
Noon – 9/17/17
Cash only once
2016 Co-Champions
Choice Altier and Linda Gunnin
Club Officers: Jacquie Campbell - President, Pat Elliot – 1
Vice-President, Choice Altier –
st
2
Vice-President, Pat Bryson - Sgt.-At-Arms, Janice Goke-Kaucic, Secretary/Treasurer
nd
2017 GEORGIA 500 CLUB TOURNAMENT ENTRY FORM
(PLEASE PRINT)
Name: __________________________________ Address: ________________________________
500 Club #: _______
City: ____________________________________ State: ____ Zip: ____________
USBC#___________
Home Phone No.: _____________________________ E-mail: ____________________________________________________
Association Name: ___________________________Average: ______
600 Club Member: ______ Yes
_______ No
Average Verified By:
Session Preference:
1.
Average Printout From USBC () ______________
Sat., Sept. 16 – 4 PM __________
(enclose with entry)
Sun., Sept 17 – Noon __________
1. 2016-17 Yearbook: _________
(bring a copy with you to tournament
Please return completed entry by 8/31/17 to:
2. League or Association Secretary/Manager signature:
Janice Goke-Kaucic
GA 500 Club Secretary
________________________________________________
38 Windsor Road
Newnan, GA 30263-4701
……………………………………………………………………………………………………………………………………….
Options
Cost
Amount Paid
For questions or concerns
Tournament Fee
$34.00 ___________
contact Janice at:
Yearly Renewal Fee
$ 2.00 ___________
770-304-2251,
New Member Fee
$ 6.00 ___________
, or
jgoke_kaucic@charter.net
Shirt (S,M,L,XL)
$21.00 ___________
Size _______
(XXL-4XL)
$23.00 ___________
Size _______
Make Checks Payable To:
500 Club Pin
$ 2.00 ___________
Georgia 500 Club
Mail Shirt/Pin
$ 5.00 ___________
Shirts and pins can be picked up on day of tournament or mailed to you with the “Mail Shirt/Pin” fee.
TOTAL AMT SUBMITTED:
___________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal