ENTRY FORM			Jacaranda Festival of Croquet

Full Name ……………………………………………………………………………

Address   ……………………………………………………………………………

Telephone No. ………………………… Handicap …… AHS Index ………… Club …………………

Signature & Date …………………………………………………  …………………………………………………

Cheques only, payable to Croquet NSW Inc.    $………………

Post to: Croquet NSW Inc, PO Box 5096, Marrickville NSW 1475