Please Indicate How You Heard About the Event

CSSC EVENT ENTRY FORM

Event CSSC National Chess Open Finals 2017 Venue Edinburgh Chess Club, 1 Alva Street, Edinburgh, EH2 4PH Date of event Wednesday 12 – Friday 14 July 2017 Closing date for entries Wednesday 5 July 2017 Start time 13:00 Event

Please complete all sections in BLOCK CAPITALS. CSSC membership numbers must be included. You may find it helpful to ‘Tab’ from one field to another.

Title: Forename: Surname: Gender: Over 18: Yes No Home Address

Postcode CSSC membership no. Staff/Payroll no. Home Telephone no. Work Telephone no. Mobile Telephone no. Email

Next of Kin NoK Contact Tel. no.

National Grading

ECF Membership no.

(if applicable)

Section 2: Advertising Please indicate how you heard about the event:

Leisure Scene magazine Other CSSC Event Friend/Colleague CSSC Website Poster in the workplace Departmental Intranet Email

Section 3: Entry Fee

No Entry Fee Light refreshments provided by the venue

Financial assistance for any accommodation and travel costs is available from the National Travel Policy. Details of which can be found at https://www.cssc.co.uk/subsidies/national-travel-policy/ • Anyone who is not a member of the CSSC and wants join can obtain a membership form from Matthew Taylor on 01494 888439 or the organiser (if different). If you are unable to quote your CSSC number e.g. lost card, a form for a replacement card can be found online or please contact our customer services team on 01494 888444.

Section 4: Important Information

Don’t forget that this event is also open to your friends or family members. Under our Linked membership scheme, up to three of your friends or family members can join CSSC and take part in our events. Membership is also available to staff working in the Public Sector such as NHS, local government, teachers, the police, fire fighters and HM Armed forces personnel.

Any queries to the event organiser Any enquires directly linked to the event please contact Ihor Lewyk on 03000 518054 or by e-mail [email protected] or [email protected]

Medical: Please let us know if any member of your team has any physical or medical conditions Yes/No (Delete as applicable)

If yes, please give details Any Dietary Requirements

IMPORTANT: These events are active and players should be aware of the physical activities involved. CSSC reserves the right to cancel the event if under subscribed.

All CSSC members taking part in the event are covered by CSSC Sports and Leisure Public Liability Insurance. Please note that this policy is NOT a Personal Accident Policy. Members are encouraged to take out their own insurance policy.

The organiser reserves the right to cancel any event if there are insufficient entries. The organiser’s decision on all matters is final. All entries to be received by 5/07/2017

Signed: Date:

Please send all entries to:

Post: Matthew Taylor CSSC Sports & Leisure 7/8 Buckingham Place Bellfield Road High Wycombe Bucks HP13 5HW Photocopied forms will be accepted Contact: [email protected] 01494 888439

Office use only: Date entry received: …………………. Date acknowledgement sent: ………………….