THE STEUBER CLASSIC
AMERICAN RULES "SINGLES" TOURNAMENT
ENTRY FORM
Name:_____________________________USCA Handicap:____________
Address:_____________________________________________________
Cell Phone #:_____________________Email:_______________________
Enclosed is my Entry Fee of $295, payable to CFA ( or the Croquet Foundation of America). Or charge my credit card as follows:
Amex__/Visa__/MC__ for $_________CC#_________________________
Exp. Date________ Code_____________
Billing Address Zip Code_____________
Mail or email this form to:
Marie Sweetser at CFA
700 Florida Mango Road
West Palm Beach, FL. 33406
membership.director@croquetnational.com
I am unable to attend, enclosed is my donation of $___________ made payable to the Croquet Foundation of America (CFA).
The Croquet Foundation of America, Inc. is a 501(c)(3) not-for-profit corporation whose mission is to develop and promote the amateur sport of croquet in America, with a strong emphasis on charitable and educational programs for the benefit of our community and society.
WAIVER AND RELEASE OF LIABILITY
I hereby relieve, release and forever discharge and agree to indemnify and hold harmless the United States Croquet Association, the National Croquet Club, the Tournament Committee, the National Croquet Center and the Croquet Foundation of America, their servants, agents,and employees from any and all claims and demands of any and every kind and character for injury to my person or damage to property as a result of any participation in the CFA Tournament.
Signature:________________________________Date:__________________
The CFA is a 501(c)(3) not-for-profit corporation incorporated under the laws of the State of New York. Federal Taxpayer ID Number 13-3008366. Florida Department of Agriculture & Consumer Services #CH4098. A copy of the Official Registration & Financial Information may be obtained from the Division of Consumer Services by calling Toll-Free (800-435-7352) within the State Registration does not imply endorsement, approval, or by the State. Proceeds will be used to enhance the facilities at the National Croquet Center.
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