Singles play begins Friday, May 19, 2017 at 1pm. Scotch Doubles play begins Saturday, May 20, 2016 at 1pm. All start times are subject to
change without notice. Failure to abide by tournament policies may result in immediate expulsion from this tournament.
If you wish to enter both Scotch Doubles and Singles, both partners can use this form (3 entries total). If you are only entering Singles, 1
player per form, please, and enter your player information in the appropriate scotch doubles gender section. Entries must be submitted
by mail. Make checks payable to WESTERN BCA. All fees must accompany this form. Your cancelled check is your receipt. Entries must
be postmarked no later than May 11, 2017. No exceptions. Service charge for returned checks: $25.00.
MALE PLAYER INFORMATION:
Name: _____________________________________________
Email: _____________________________Phone: __________
Rating: FargoRate _____WBCA ___________________APA ___
If Junior (under 21), my DOB is __________________________
ENTRY INFORMATION
MEN’S SINGLES DIVISIONS (choose 1 based on Fargo Rating)
Men’s Master (600 & above) Race to 5/$55+$20+$5=$80
Men’s Open A (520-599) Race to 4/$45+$20+$5=$70
Men’s Open B (519 & below) Race to 4/$35+$20+$5=$60
FEMALE PLAYER INFORMATION:
Name: _____________________________________________
Email: _____________________________Phone: __________
Rating: FargoRate _____WBCA ___________________APA ___
If Junior (under 21), my DOB is __________________________
Entries must be submitted by mail. Make checks payable to WESTERN BCA. All
fees must accompany this form. Your cancelled check is your receipt. Entries
must be postmarked no later than May 11, 2017. No exceptions. Service charge for
returned checks: $25.00.
This form will not be accepted without signatures of all players entered above.
Our signatures below indicate our agreement that our names and likenesses may
be reproduced for publication on the Western BCA website and in other media
outlets, including the internet. We further understand that if we win any money in
this event we will each be required to provide a social security number or International ID before any funds are distributed. False information will result in immediate expulsion from the tournament and forfeiture of all fees and any winnings.
WOMEN’S SINGLES DIVISIONS (choose 1 based on Fargo Rating)
Women’s Master (421 & above) Race to 5/$55+$20+$5=$80
Women’s Open (420 & below) Race to 4/$45+$20+$5=$70
MIXED SCOTCH DOUBLES DIVISION (choose 1 based on Fargo total)
1200 & above Race to 5/$75+$20+$5=$100
1000-1199 Race to 4/$75+$20+$5=$100
999 & below Race to 3/$75+$20+$5=$100
* Races may change based on entries. TOTAL ENCLOSED: _________
**Green fees include table time for this event and practice. Please send completed form to: Darcy Williams, Tournament Registrar,
980 54th Street, Springfield, OR 97478
Questions: Call Rick Tillett 541-404-0453 or Darcy Williams 541-517-9816
Signed:______________________________________ & ______________________________________Date: ___________________