Fort Wayne Billiards

Indiana State Entry Form

Indiana State Championships Sign Up Form

March 26-30 Registrations are due no later than February 12th to any drop spot location. You must pay your entries by the deadline. $25 late fee after 2/12/2013 If you are not sure what division you belong. You can access the A division and Masters list at www.fwbilliards.com or www.iamoa.org
Team Name
Choose Team Division
Men's Master -- $350Men's A -- $250Men's B -- $200Women's Master -- $280Women's Open -- $180None
Player 1 (Captain)
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Choose Singles Division
Men's Master Singles -- $80Men's A Singles -- $70Men's B Singles -- $60Ladies Master Singles -- $70Ladies Open Singles -- $60None
Player 2
Choose Singles Division
Men's Master Singles -- $80Men's A Singles -- $70Men's B Singles -- $60Ladies Mastes Singles -- $70Ladies Open Singles -- $60None
Player 3
Choose Singles Division
Men's Master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master Singles $70Ladies Oepn Singles $60None
Player 4
Choose Singles Division
Men's Master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master Singles $70Ladies Open Singles $60None
Player 5
Choose Singles Division
Men's Master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master Singles $70Ladies Open Singles $60None
Player 6
Choose Singles Division
Men's master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master Singles $70Ladies Open Singles $60None
Player 7
Choose Singles Division
Men's Master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master Singles $70Ladies Open Singles $60None
Player 8
Choose Singles Division
Men's Master Singles $80Men's A Singles $70Men's B Singles $60Ladies Master SIngles $70Ladies Open Singles $60None
Junior Scotch Doubles
Total Amount of Entry

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