Pub/Team Name:

………………………………………………………………

Address:

………………………………………………………………

………………………………………………………………

(Postcode)

………………………………………………………………

Telephone:

………………………………………………………………

Name of contact:

………………………………………………………………

Telephone   (Home):

………………………………………………………………

(Work):

………………………………………………………………

Do you wish to enter a second team?  If so, please complete the following:

Team Name:

………………………………………………………………

Name of contact:

………………………………………………………………

Telephone (Home):

………………………………………………………………

(Work):

………………………………………………………………