SHAMROCK O-RINGEN '99 ENTRY FORM
PLEASE COMPLETE FORM IN BLOCK CAPITALS
Name and Address for Programme/Correspondence:

Date Rcd.	Payment By	Entry No.
	
OFFICIAL USE ONLY	
Name: ................................................................................ Telephone No.: ...............................................

Address: ......................................................................................................................................................

......................................................................................................................................................................

.............................................................................................................Country: .........................................
 
We acknowledge that entries are accepted on the understanding that competitors take part at their own risk.

C
L
A
S
S	

COUR
S
E	

FULL NAME
(Surname First)	

Home Town	

CLUB (*Abbr)	

YEAR OF BIRTH	Tick Each Day Entered			Tick Preferred Day 1 Start			TOTAL FEES IR£	
Please Tick if Day 2		

1	

2	

3	EARLY	
MID	LATE		
IOF
WRE	
'99 IOC	

 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	

 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	

 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	
 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	
TOTAL EVENT ENTRY FEE
Plus IR£2 per entry form for programme, Results and postage
TOTAL FEES ENCLOSED IR£												 			
												IR£ 2.00			
												 			
(*) Please give FULL NAME of Club(s) below:

* ............................................................................

* ............................................................................