2020 columbus day seniors entry formoptional programs charge my account $ card # exp. date 3-digit...
TRANSCRIPT
(Mr.) (Ms.) Name
Address
City State Zip
Birth date SSN# – –
Home Phone or Cell #
USBC# Recruited by
MANDATORY - Ever rerated or re-assigned an average higher than your entering league average?
q Yes q No USBC rule #319 applies
q I have a U.S. Military background and receive a $25 discount on my $200 entry
Team Captains – We need a separate form for each member, please no staples.
q Check here if you want us to send each team member a confirmation. Bowlers who pay for themselves will automatically receive a confirmation as their receipt.
Team Captain:
Team Name:
Your squad choice 2nd Choice TIP – don’t make travel plans until confirming squad times.
q Optional All-Events $20
q Handicap 3-game Sweeper $40 q Wednesday 5 pm
q Scratch 3-game Sweeper $40 q Wednesday 5 pm
q Handicap No Tap $40 q Saturday 5 pm q Tuesday 5 pm
q Mixed Doubles $20 per person q Tuesday 5 pm q Thursday 5 pm (Each day is a separate prize fund)
TOTAL SUBMITTED INCLUDING $200 ENTRY FEE $
(Entry fees shown above increase if paid onsite, see separate article.)
Participant’s Agreement: I have read and understand the rules of the Columbus Day Seniors staged at The Orleans Bowling Center in Las Vegas, Nevada. Upon the acceptance of my application to be a contestant, I agree to abide by the rules and regulations and that I have read and meet eligibility requirements. (Participant Signature)
Make checks payable to High Roller. NEW ADDRESS: High Roller, PO Box 33009, Las Vegas NV 89133 1-800-257-6179 or 1-702-228-7308 • Fax with credit card:1-888-794-2010 • Enter online with credit card at www.high-roller.com
OPTIONAL PROGRAMS
Charge my account $
Card #
Exp. Date 3-Digit CRC
Signature
Name on card
CREDIT CARD PRICING Add 5% to your total for credit card use.
q Please put me on a team!
(Entry fee needs to be paid)
For oFFice Use only
2020 Columbus Day Seniors Entry Form
Team Captains – List your lineup, it will be the same for Team, Doubles & Singles. Doubles teams
are #1 & #2, and #3 & #4
1.
2.
3.
4.
Players cannot receive prizes without SS# on file and cannot receive an age related prize without birth date on file.
Total Amount Submitted $