Entry Form for Surrey 1-Hit Epee (Individual) Championships.  If you are writing on a paper print then please write clearly.

1. First Name*  …………………………………

2. Surname*

3. Male / Female (select as applicable)*

4. Club?*

if "Other please state club:

5. Email: (please cut / paste from known working address to avoid errors):*
if you do not have an email or chose not to enter one then please type  "none".  Email policy available on request.

6. Postal address (optional if you give an email and phone number.  We cannot guarentee data security).

Address line 1:  
Address line 2:
Address line 3:
Postcode:

7. Phone 1*

8. Phone 2 (on the day emergency number)*

9. BFA Membership Number:*  Expires:* If in post/progress then state so in box.

10. Year of birth (only if you are U18)
(Must be 13 or over on 1st Jan in season of event)

11. Competitors must ensure that all kit is of a safe and serviceable nature, and that BFA safety guidelines are met.

12. Signature (if U18 then signature of parent /guardian to be added to printed copy to accompany cheque)
I accept that the organisers cannot be held responsible for any accident, loss or damage sustained at the competition.


signed .....................………………………...........................……    date ............................................

13. Payment: Cheque for £12.00/event in advance (or £20 on the day), payable “S.C.F.U.”  
Before pressing "submit" please print this page (May need page setup -> A4) then post with cheque to:
Roger Barnes: 34 Caroline Close, Valley Road, Streatham, SW16 2XU.

Thank you for your entry to this competition.  After printing out a paper copy to post then please press "SUBMIT" below.   This information will not be automatically collected unless you press submit.    If in doubt try again (so long as the name is the same we will cope!).
If you have any message / notes / comments for the organiser then enter them here



This form was last updated: April 29, 2008
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