ENGLAND SQUASH SOUTH EAST

AREA CLOSED CHAMPIONSHIPS 2006

7^th - 8^th October 2006

ENTRY FORM

Venue:	Bluecoat Sports Centre Christs Hospital Horsham West Sussex RH13 0YB
	Tel:01403 247618

Please note: Depending on the number of entries, it may be necessary to run the tournament at two venues. The venue for your event will be posted on www.englandsquash.com along with the registration times for each age group preceding the tournament.

Please complete in BLOCK CAPITALS :		BOYS	GIRLS
I wish to enter : (Please tick)	Under 17
	Under 15
	Under 13

	FULL NAME :
	ADDRESS
			POSTCODE :
E-MAIL								MOBILE
TEL NO		Home				Parents Daytime
FAX NO		Home				Parents Daytime
	AGE ON 08/10/06						DATE OF BIRTH
	PLACE OF BIRTH						SCHOOL
	CLUBS
	COUNTY ELIGIBILITY				COUNTY RANKING
	NATIONAL RANKING
	ES GRADE (Please circle)			C1 C2 D1 D2 E1 E2 F1 F2
	T SHIRT SIZE REQUIRED (Please circle)			Small Medium Large X Large
	ENGLAND SQUASH MEMBERSHIP NO. Your England Squash membership number is mandatory. If you are unsure of your number, please contact Lewis Baker on 0161 438 4317. Your entry will be invalid if a number is not inserted.

CLOSING DATE

All entries must be received no later than 12.00 pm on Wednesday 27^th September 2006

Please Turn Over

Important Notes – Please Read

· The finalists of each County Closed are guaranteed a place in the Area Closed Championships provided an entry is received by the closing date

· Entries are limited to a maximum 32 draw for Boys and Girls in each age group

· If you wish to check your entry has been received, please call your England Squash Area Office

· The venue for your event will be posted on www.englandsquash.com along with the registration times for each age group preceding the tournament.

Child Protection

Photography and Recorded Images

England Squash recognises the need to ensure the welfare and safety of all young people in sport. In accordance with our child protection policy we will not permit photographs, video or other images of children/young people to be taken without the consent of the parents/carers and children/young people.

A copy of the full guidelines is available from www.englandsquash.com

England Squash will take all possible steps to ensure these images are used solely for the purposes they are intended. If you become aware that these images are being used inappropriately you should inform England Squash immediately.

I (parent/carer) consent to England Squash photographing or videoing my child’s involvement in the Area Closed Championships 2006 for the purposes of publicising and promoting the sport, or as a coaching aid.

Signed: ______________________________________ Date: _____________________

I (child/young person) consent to England Squash photographing or videoing my involvement in the Area Closed Championships 2006.

Signed: ______________________________________ Date: _____________________

Please ensure both the player and Parent/Carer have signed and dated above

I enclose my entry fee of £15.00 (cheques made payable to England Squash)

I do not wish to be included on the reserve list if not accepted initially for the draw

I agree to abide by the England Squash Code of Conduct.

Please forward the completed entry form and payment to:

England Squash, Sports Development Unit, University of Brighton, Falmer, Sussex, BN1 9PH Tel: 01273 644103

The closing date for entries is 12.00pm on Wednesday 27^th September 2006. Any entries received after this time and date will not be accepted.

Please note no entry will be accepted unless accompanied by payment.