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Universal Cues 2015 American CueSports Alliance
National Championships
Team Entry Application
Competition Dates: 9-Ball Team (May 13-15 mornings)/ 8-Ball Team (May 13-15 afternoons and evenings)
“EARLY BIRD” ENTRY POSTMARK – Jan. 31, 2015 - 20% discount on your “Regular” entry!!! Postmark your entry by Monday,
March 23, 2015 and pay the Regular Entry Fee! Late entries postmarked by Monday, April 6, 2015, must include a $25 late fee.
$25 GREENS FEE/player/per event is included in every entry fee ! Pool tables will be open for PLAY/ PRACTICE/ MINI-TOURNEYS!
League Name ________________________
League # _______
League Operator _____________________
City __________________ St./Pr ________
Contact Phone #: ____________________
Division Name (if diff. than league name)
___________________________________
TEAM NAME _________________
_____________
Divisions
(Check only one
per division)
Entry Fees
Postmark Deadlines:
Staying at the Tropicana?
Men’s/Mixed Advanced 9 Teams
Women’s Advanced 9 Teams (NEW!)
Men’s/Mixed Open 9 Teams
Women’s Open 9 Teams
Men’s/Mixed Standard 9 Teams (NEW!)
Men’s/Mixed Advanced 8 Teams
Women’s Advanced 8 Teams
Men’s/Mixed Open 8 Teams
Women’s Open 8 Teams
Men’s/Mixed Standard 8 Teams
Women’s Standard 8 Teams
1/31/15
Early Bird
Yes
No
3/23/15
Regular
Yes
No
4/6/15
Late
Yes
No
$255*
$255*
$195*
$195*
$195*
$445*
$420*
$365*
$340*
$285*
$260*
$300*
$300*
$225*
$225*
$225*
$525*
$500*
$425*
$400*
$325*
$300*
$325*
$325*
$250*
$250*
$250*
$550*
$525*
$450*
$425*
$350*
$325*
$330
$330
$270
$270
$270
$570
$520
$490
$440
$410
$360
$375
$375
$300
$300
$300
$650
$600
$550
$500
$450
$400
$400*
$400*
$325*
$325*
$325*
$675*
$625*
$575*
$525*
$475*
$425*
[ * Must Provide Tropicana Hotel Room Booking Confirmation Number Below.]
- 9-Ball Teams: 3-person // Men’s/Mixed 8-Ball Teams: 5-person // Women’s 8-Ball Teams: 4-person
Every entry fee above includes a $25/player greens fee! Pool tables will be Open!!
Tropicana Hotel Room Booking Confirmation # (REQUIRED if “Yes” above):___________
TO GAIN THE TROPICANA DISCOUNTED HOTEL RATES…AND…TO HAVE RESORT FEES WAIVED,
you MUST reserve online at: https://resweb.passkey.com/Resweb.do?mode=welcome_ei_new&eventID=11615938
PLEASE ATTACH A COPY OF YOUR LEAGUE STATS VERIFYING ELIGIBILITY WITH EACH ENTRY FORM!
In order to prevent a late entry fee, please postmark all entries by 3/23/15. In the event you are not able to fill out the complete roster
form by this deadline due to late playoffs or qualifiers, please indicate a “TBD” on the Name line and submit all appropriate fees by
3/23/15. All name changes or additions should be submitted to the ACS League Office no later than 5/1/15.
1). Captain: ________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
7). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
2). Name: __________________________________________
City: ________________________________ State: _______
Contact Phone Number: _______________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
8). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
3). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
9). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
4). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
10). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
5). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
PAYMENT (CHECK ONE)
Check M. O. VISA MASTER CARD DISCOVER PAYPAL
Credit Card #: _________-__________-_________-___________
Expiration Date: __________/_________
Total Amount To Be Charged For This Entry $______________
+ 5% ACS merchant finance fee for credit card/ PayPal entries
Cardholders Name (as it appears on the card)
_____________________________________________________
CARDHOLDER’S SIGNATURE:___________________________
6). Name: __________________________________________
City: _________________________________ State: _______
Email: ____________________________________________
Team played on during league session __________________
Session played in: Summer Fall Winter Spring
Important! For entries postmarked after March 23, 2015, only
Traveler’s Checks, Cashier’s Checks, Money Orders, Credit Cards &
ONLINE ENTRY will be accepted.
AMERICAN CUESPORTS / 101 S. Military Ave., Ste. P - #131/ Green Bay, WI 54303
OR FAX TO: 920-662-1706
Refund requests must be in writing and in the ACS office by April 29, 2015. All refunds will be charged a $10.00
handling fee. All refunds will be mailed after the tournament. NO EXCEPTIONS! Questions Call 1-920-662-1705
MAIL THIS FORM TO:
I have read and agree to abide by the rules and regulations set-forth in the 2015 ACS National Championship Guidelines as published and enforced by
the American CueSports Alliance. For a copy of the tournament guidelines contact American CueSports, your local league operator or go to
www.americancuesports.org. ALL TEAM ENTRIES MUST BE SUBMITTED THROUGH YOUR LEAGUE OPERATOR.
Team Captain Signature: __________________________ Date: ________ League Secretary Signature: ___________________________ Date: ________