Please fill out in BLOCK
CAPITALS
Name:___________________________
Address:_________________________
_________________________________
_________________________________
Club:___________________________
Rating:______
I.C.U Number:_____
I request a
travelling bye in round:_____
+ PLEASE SEND
ENTRIES TO:
John Cassidy,
Loyola,
Ennis V95FX9D,
Co.
ENTRY FEES:
Adults €40
Juniors €25
Make cheques payable to: John
Cassidy