2017 golf nb tournament entry form
2017 GOLF NB TOURNAMENT ENTRY FORM Golf NB, 500 Beaverbrook Court, Suite 440, Fredericton, NB E3B 5X4 Phone: (506) 451-1324. Fax: 1-888-307-2963. [email protected] . www.golfnb.ca
*REGISTRATION FOR ALL GOLF NB EVENTS OPENS MAY 1, 2017* I wish to enter the following tournaments(s): (check all that apply and forward entry form with full payment to the address above)
NB MEN’S MID-MASTER CHAMPIONSHIP (40 Years of Age by Aug. 22, 2017) ….…………………………..… July 24-26, 2017
NB FAMILY CLASSIC / ADULT JUNIOR (Please circle the appropriate division below) ………………………… August 14, 2017 Please Circle: Father/Son Father/Daughter Mother/Son Mother/Daughter Adult Jr./Male Adult Jr./Female
NB LADIES FOUR BALL ….…………………………………………………………...…………………..……………..… June 11, 2017 NB FOUR BALL (Men’s & Senior Men’s Competitions) ……………………………...……………..…………..…… June 17-18, 2017 BOUCTOUCHE EAST COAST JUNIOR CHAMPIONSHIPS …...………….………...…………….…………….… June 27-28, 2017 NB PEE WEE CHAMPIONSHIP …………………………….………………….…………..……………….….………….. July 5-6, 2017 NB JUNIOR CHAMPIONSHIP …………………………………………………............................………..….………….. July 5-7, 2017 NB LADIES PROVINCIAL CHAMPIONSHIPS ……...………………………………..………...…….………………….. July 9-11, 2017 RBC DOMINION SECURITIES NB MEN’S AMATEUR CHAMPIONSHIP (Amateur & Mid-Amateur Divisions)... July 13-16, 2017 NB MEN’S SENIOR CHAMPIONSHIP (55 Years of Age by Sept. 11, 2017)….…………………………………..
July 24-26, 2017
$100.00 $175.00 $105.00 $90.00 $125.00 $165.00 $195.00 $175.00 $175.00 $100.00
Note: All entry fees are subject to HST _________________________________________________________________________________________________________________________ NAME: ________________________________
DATE OF BIRTH: ________________________
E-MAIL: ________________________________
ADDRESS: _____________________________
CITY: __________________________________
POSTAL CODE: _________________________
TELEPHONE: ___________________________
GOLF CLUB: ___________________________
GOLF CANADA CARD #:__________________
I WOULD LIKE TO MAKE A DONATION IN SUPPORT OF JUNIOR GOLF:
$5.00
$10.00
$25.00
$50.00
Other: _________________
Please note that tax receipts will be issued for all donations of $20.00 or more.
Name:
________________________________________ (Four Ball Partner’s Name)
Golf Club: __________________________
Golf Canada Card #:_______________
Name:
________________________________________ (Family Classic or Adult/Junior Partner’s Name)
Golf Club: __________________________
Golf Canada Card #:_______________
METHOD OF PAYMENT – Entries will not be processed without payment. Faxed entries must include payment by VISA or Master Card. Cheque or Money Order enclosed (Payable to Golf NB): ____________________
TOTAL PAYMENT: $____________________________________
Visa or M/C #: _____________________________________________________
Expiry Date: ___________________
Name on Card: ____________________________________________________
Signature: ____________________________________________
Billing Address: ____________________________________________________
City: _________________________
CVV / CVC #:__________
Postal Code:__________
REFUND POLICY: Application fees will be refunded if Golf NB is notified (506-451-1324) of the player’s intention to withdraw prior to the application deadline. Application fees will not be refunded after the application deadline without a medical certificate. Refunds are subject to a $25 administrative fee. Once selected into a championship, players are expected to participate. If a player wishes to withdraw prior to the start of a championship, he/she must notify the Golf NB well in advance in order to ensure an alternate fair opportunity to play. Failure to comply may result in DISQUALIFACTION from future provincial competitions. WAIVER OF MEDIA RIGHTS: In consideration for Golf NB’s services in sponsoring the tournament, I hereby grant and assign to the Golf NB, without limitation, my individual television, radio, motion picture, print advertising, Internet and all other related media rights with respect to my participation in the tournament.
*REGISTRATION FOR ALL GOLF NB EVENTS OPENS MAY 1, 2017* I wish to enter the following tournaments(s): (check all that apply and forward entry form with full payment to the address above)
NB MEN’S MID-MASTER CHAMPIONSHIP (40 Years of Age by Aug. 22, 2017) ….…………………………..… July 24-26, 2017
NB FAMILY CLASSIC / ADULT JUNIOR (Please circle the appropriate division below) ………………………… August 14, 2017 Please Circle: Father/Son Father/Daughter Mother/Son Mother/Daughter Adult Jr./Male Adult Jr./Female
NB LADIES FOUR BALL ….…………………………………………………………...…………………..……………..… June 11, 2017 NB FOUR BALL (Men’s & Senior Men’s Competitions) ……………………………...……………..…………..…… June 17-18, 2017 BOUCTOUCHE EAST COAST JUNIOR CHAMPIONSHIPS …...………….………...…………….…………….… June 27-28, 2017 NB PEE WEE CHAMPIONSHIP …………………………….………………….…………..……………….….………….. July 5-6, 2017 NB JUNIOR CHAMPIONSHIP …………………………………………………............................………..….………….. July 5-7, 2017 NB LADIES PROVINCIAL CHAMPIONSHIPS ……...………………………………..………...…….………………….. July 9-11, 2017 RBC DOMINION SECURITIES NB MEN’S AMATEUR CHAMPIONSHIP (Amateur & Mid-Amateur Divisions)... July 13-16, 2017 NB MEN’S SENIOR CHAMPIONSHIP (55 Years of Age by Sept. 11, 2017)….…………………………………..
July 24-26, 2017
$100.00 $175.00 $105.00 $90.00 $125.00 $165.00 $195.00 $175.00 $175.00 $100.00
Note: All entry fees are subject to HST _________________________________________________________________________________________________________________________ NAME: ________________________________
DATE OF BIRTH: ________________________
E-MAIL: ________________________________
ADDRESS: _____________________________
CITY: __________________________________
POSTAL CODE: _________________________
TELEPHONE: ___________________________
GOLF CLUB: ___________________________
GOLF CANADA CARD #:__________________
I WOULD LIKE TO MAKE A DONATION IN SUPPORT OF JUNIOR GOLF:
$5.00
$10.00
$25.00
$50.00
Other: _________________
Please note that tax receipts will be issued for all donations of $20.00 or more.
Name:
________________________________________ (Four Ball Partner’s Name)
Golf Club: __________________________
Golf Canada Card #:_______________
Name:
________________________________________ (Family Classic or Adult/Junior Partner’s Name)
Golf Club: __________________________
Golf Canada Card #:_______________
METHOD OF PAYMENT – Entries will not be processed without payment. Faxed entries must include payment by VISA or Master Card. Cheque or Money Order enclosed (Payable to Golf NB): ____________________
TOTAL PAYMENT: $____________________________________
Visa or M/C #: _____________________________________________________
Expiry Date: ___________________
Name on Card: ____________________________________________________
Signature: ____________________________________________
Billing Address: ____________________________________________________
City: _________________________
CVV / CVC #:__________
Postal Code:__________
REFUND POLICY: Application fees will be refunded if Golf NB is notified (506-451-1324) of the player’s intention to withdraw prior to the application deadline. Application fees will not be refunded after the application deadline without a medical certificate. Refunds are subject to a $25 administrative fee. Once selected into a championship, players are expected to participate. If a player wishes to withdraw prior to the start of a championship, he/she must notify the Golf NB well in advance in order to ensure an alternate fair opportunity to play. Failure to comply may result in DISQUALIFACTION from future provincial competitions. WAIVER OF MEDIA RIGHTS: In consideration for Golf NB’s services in sponsoring the tournament, I hereby grant and assign to the Golf NB, without limitation, my individual television, radio, motion picture, print advertising, Internet and all other related media rights with respect to my participation in the tournament.
