2015 WCM 11-Man Ballot (Laverty vs Moiseyev)
January 16th through 19th,
2015
at the Econo Lodge Hotel, 2133 Hanford Rd, Burlington, NC 27215 (336)
227-1270 (
map )
2015 11-Man World Championship Contract (Laverty vs Moiseyev)
WCDF World 11-Man Ballot Title Match Contract
Signed:
Challenger:
__________________________________________________________ Date
____________ WCDF President::
____________________________________________________ Date ____________ ACF President::
______________________________________________________ Date ____________ Match Referee:
______________________________________________________ Date ____________ Match Referee:
______________________________________________________ Date ____________ Media Specialist:
_____________________________________________________ Date ____________
|
STATE OF_________________
COUNTY OF________________
I, _________________________, a Notary Public of said County and State, do hereby certify that the above individuals personally appeared before me this day and acknowledged the execution of the foregoing instrument.
Witness my hand and official seal, this the _____ day of____________, 201__.
_________________________________ (Seal)
Notary Public
My Commission Expires:
______________________
2015 Tournament Dates | 2015 WTM 11-Man (Laverty vs Moiseyev)