SECTION 1 Registration (All information below is required in order to process this registration form).

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1 Entry forms will not be processed unless ALL information is entered and printed legibly. SECTION 1 Registration (All information below is required in order to process this registration form). SECTION 2 Check P Your Event Choices 60 & over Men s Singles Women s Singles Men s Doubles Women s Doubles Team event SECTION 3 Singles Event SECTION 4 Doubles Event SECTION 5 Team Event *4 Person Team Team Name Captain s Name Partner Needed (please check) Team Needed (please check) 2nd Name 3rd Name 4th Name *Important: Any omissions on this form will delay the official date of acceptance. *All registrants must sign a liability waiver & publicity release on-site in order to participate. For further assistance please contact Camille Ruffino at SEND ALL COMPLETED ENTRIES TO Moose International, Finance Dept., Attn: Janet Corah, 155 S. International Drive, Mooseheart, IL

2 *To complete the application process addresses and/or phone numbers for EACH participant is required. Any omissions will delay the official date of acceptance. Any reserved shift held for your team will be released and made available to other teams if forms and payment are not received within two weeks of the reservation. Tournament information will be communicated via only. Loyal Order of Moose Payment Information Card Type (please circle) Visa Master Card Discover American Express Name as it appears on Card: Credit Card Number: oooo oooo oooo oooo Amount $ Expiration Date: oo/oo CVV Code: ooo American Express CVV2 Code: oooo Signature: Notes SECTION 6 Payment Page - Due by May 27, 2018 Women of the Moose 33rd Annual Moose International Pool Tournament 2018 Event Day # of Players Cost per Person Totals Singles Wednesday (1) x $20 per person $ Doubles Thursday (1) x $20 per person $ 4 Person Team Fri/Sat. (4) x $20 per person $ Total Amount Due to Moose International $ Event Day # of Players Cost per Person Totals Singles Wednesday (1) x $20 per person $ Doubles Thursday (1) x $20 per person $ 4 Person Team Fri/Sat. (4) x $20 per person $ Total Amount Due to Moose International $ *Check, money order or credit card information must accompany all entries and must be postmarked by May 27, *Returned checks must be replaced with an alternate form of payment (No Checks) within 10 days or entry will be cancelled. *All checks and money orders should be made payable to Moose International, Finance Dept., Attn: Janet Corah, 155 S. International Drive, Mooseheart, IL and must be earmarked 2018 Pool Tournament. For Office Use Only (US Funds Only) Date Received by Finance Received by / / Date Received by Activities Received by / /

3 SECTION 7 Lodge Information & Schedule of Events Wilson, NC Lodge #989: 2705 Forest Hills Road SW, Wilson, NC (252) Moose International registration contact: Camille Ruffino (630) cruffino@mooseintl.org Moose International Coordinator of Activities: Gordie Dailey (630) On-site lodge representative: Mike Strickland (252) Come celebrate Wilson, NC Lodge 989 s 100th Year Anniversary!!! 33rd Annual Moose International Pool Tournament 2018 Tuesday June 26 12:00 pm - 9:00 pm Registration 7:00 pm Tournament Chairman/Team Captain s meeting 7:00 pm - Close Open Jukebox Night 8:00 pm 9-Ball Tournament (*to benefit Moose Charities) Wednesday, June 27 9:00 am Opening Ceremony 10:30 am Singles Competition 9-Ball Tournament (Immediately following Singles) Dinner Specials available 6:00 pm - 9:00 pm 8:00 pm 11:00 pm Live DJ Swimming pool with Tiki Bar and full kitchen (discounted passes available) Tournament & Lodge T-Shirts available for purchase Bloody Mary Specials each morning during Breakfast! Wilson, NC Lodge 989 is smoke-free (designated smoking area outside) Thursday, June 28 10:00 am Doubles Competition Scotch Doubles Tournament (Blind Draw immediately following Doubles) 8:00 pm 11:00 pm Live DJ Friday, June 29 9:30 am Team Competition (Day 1) (Immediately following awards for Singles & Doubles) Ten Ball Break Contest (Immediately following Team competition) Dinner Specials available 6:00 pm - 9:00 pm 8:00 pm - 12:00 am Trivia / DJ / Karaoke Saturday, June 30 10:00 am Team Competition Continues Awards for Team immediately following 11:00-3:00 pm Open Kitchen 8:00 pm - 12:30 am Live DJ

4 SECTION 8 Lodging Holiday Inn Express 2308 Montgomery Dr. Wilson, NC PHONE: (252) Days Inn 1801 Tarboro St. Wilson, NC PHONE: (252) Candlewood Suites 2915 Independence Drive West Wilson, NC, Direct (252) Reservations (866) MOOSE GROUP RATE: $ tax *Mention Moose International Pool Tournament and site code MOO. RESERVE A CAMPSITE ON THE LODGE GROUNDS! Call early to reserve (252) First come, first serve. LOCAL ATTRACTIONS: Wilson Baseball Museum Whirleygig Park

5 SECTION 9 GENERAL RULES (All Moose International Sports Tournaments) 1. Eligibilty - Only Loyal Order of Moose and Women of the Moose members holding an active membership at the time of the tournament will be eligible to play pool and compete for tournament prizes. All players must present a valid photo I.D. and a valid Moose membership card. 2. Good sportsmanship will be the prevailing attitude throughout the tournament. Tournament Director and/or Moose International may recommend disqualification of a player for unsportsmanlike conduct or tactics detrimental to the tournament. 3. Gambling on the tournament is not permitted and will result in disqualification and forfeiture of prize money. 4. No entry forms will be accepted unless all information is entered and entry fees are paid in full, by the established registration deadline. 5. Payment - All remittances must be in the form of a check, money order or credit card in U.S. funds. Checks and/or money orders should be made payable to Moose International and earmarked with the current year and name of tournament. 6. Refund Policy - Participants will be eligible to receive a full refund when cancelling prior to the registration deadline date. After this date, no refunds will be issued, regardless of the circumstances. No entry fees will be refunded if it is found that some teams or individuals have failed to comply with all the rules and regulations governing this tournament. This policy will be strictly enforced in all Moose International tournaments. 7. Substitute Policy - In cases of death, injury, sickness, or other emergency, Moose International may approve a substitute s participation. All substitutes must present a valid photo I.D. and a Moose membership card. Moose International will not be involved in the exchange of any monies between the involved parties either relating to registration fees or prize money awarded. Moose International retains the right to authorize and/or decline, any substitute s participation. Substitutes will be authorized to participate without pre-registration as many times as needed for unexpected absences of pre-registered participants. 8. Youth Policy - On occasion, youth may be permitted to participate through a special approval process handled through Moose International. This process involves a notarized waiver and documentation of the youth s age and their relationship to an immediate family member that is an active Moose member in good standing. Youth ages must be accompanied by a parent/guardian at all times during the event, and the parent/guardian assumes all legal responsibility for the youth s actions. If the youth is 18 or older, he/she assumes full legal responsibility for their own actions by signing the waiver, and will not require full time supervision; but must still provide proof that an active Moose member is an immediate family member. Moose International will review each request on a case-by-case basis to ensure that all criteria are met. Please your request to Coordinator of Activities and Heart of the Community, Gordie Dailey, Gdailey@mooseintl.org, who will approve and facilitate is process on a case by case basis.

6 SECTION 10 International Pool Tournament Rules 1. Members participating in the International Moose Pool Tournament must hold active membership at the time of registration and at the time of the tournament. A valid membership card, as well as valid photo identification, must be furnished at tournament check-in. 2. All events are double elimination. (Singles, Doubles and 4-Person Team) 3. For Team Competition, the four players registered together on one tournament registration form will comprise the 4-person team. The only exceptions are: One of the registered team members is unable to participate, at which time Rule 10 regarding substitute players will be invoked. Players who register for only Singles or Doubles Competition can be grouped into 4-person teams on site should there be enough of those registrants interested in participating in Team Competition. 4. The Protest Committee will be comprised of the International Activities Committee representative and two captains at-large. 5. The Competition Chairman and Head Referee may recommend disqualification of a player to the Tournament Chairman for unsportsmanlike conduct or tactics detrimental to the tournament. Such disqualifications result in forfeiture of entry fees and rights to prize money. 6. The Referee will be alerted to errors, fouls, and interference. He will verify, and rule on fouls when approached by opposing players in a game. Only the opposing shooter may call fouls. 7. Eligibility - A player who has paid an entry fee to a tournament of $ or more and doubled his money in that tournament in the past three years, and is listed in the top 65 point positions of the Professional Billiards Association list, is ineligible to participate in the International Moose Pool Tournament. The Tournament Committee also reserves the right to disqualify any person considered a touring pro. If there are any questions concerning eligibility, players must submit a request for approval to the Tournament Committee. 8. Names on entries will remain the same except in cases of death, accident, sickness, or an emergency. Changes must be approved by the Tournament Chairman. 9. Players must report to the staging area within five minutes of being called. If not, they will forfeit the match. 10. American Poolplayers Association (APA) - The APA shall be the governing authority for any rules not addressed here or for any rules in question.