Credit Card Number: Expiration: /
On Course with the EWGA Casa de Campo, Dominican Republic June 6 - 9, 2013 Member #__________________ or Guest of ______________________________________________________ Name: _____________________________________________________________________________________ Last First Company: ________________________________________ Chapter: __________________________________ Title: _______________________________________________________________________________________ Mailing Address: ____________________________________________ Preferred address: Home___Business___ City, State, Zip: _______________________________________________________________________________ Daytime Phone: ______________________________________ Evening Phone: ___________________________ Fax: _____________________________________ Email: _____________________________________________
New Golfer Beginner Intermediate Advanced I will be playing golf on: Friday, June 7 Saturday, June 8 Sunday, June 9 Golf Skill Level:
Arrival Date: _________________________ Round trip Airport Transportation @ $40:
Departure Date: __________________________
Sharing with, Guest’s Name: ______________________________________________________ Room Preference:
___King
___Double
___Smoking
___Non Smoking
The registration fee is $1050 plus $40 for round trip airport transportation (at any airport) for a grand total of $1090 per person–Rate is based on single or double occupancy. Includes airport transfers, accommodations, open bar, 3 meals a day, and limitless golf.
Check Enclosed or Charge my credit card:
American Express
Visa
MasterCard
(Checks payable to EWGA in U.S. Funds drawn on a U.S. or International Bank. “U.S. FUNDS” must be pre-printed on International checks).
Name as it appears on the card: Credit Card Number:
Expiration:
/
(MM/YY)
SEC (Security Code):
(3 or 4 digit code located on front/back of card)
Cardholder’s Signature:_________________________________________________________________ Please return Registration Form and Payment to: Amanda Hoey, EWGA Headquarters 300 Avenue of the Champions Suite 140, Palm Beach Gardens, FL 33418-3615 Phone: (800) 407-1477 Ext 12. Fax: (561) 691-0012 or [email protected]
New Golfer Beginner Intermediate Advanced I will be playing golf on: Friday, June 7 Saturday, June 8 Sunday, June 9 Golf Skill Level:
Arrival Date: _________________________ Round trip Airport Transportation @ $40:
Departure Date: __________________________
Sharing with, Guest’s Name: ______________________________________________________ Room Preference:
___King
___Double
___Smoking
___Non Smoking
The registration fee is $1050 plus $40 for round trip airport transportation (at any airport) for a grand total of $1090 per person–Rate is based on single or double occupancy. Includes airport transfers, accommodations, open bar, 3 meals a day, and limitless golf.
Check Enclosed or Charge my credit card:
American Express
Visa
MasterCard
(Checks payable to EWGA in U.S. Funds drawn on a U.S. or International Bank. “U.S. FUNDS” must be pre-printed on International checks).
Name as it appears on the card: Credit Card Number:
Expiration:
/
(MM/YY)
SEC (Security Code):
(3 or 4 digit code located on front/back of card)
Cardholder’s Signature:_________________________________________________________________ Please return Registration Form and Payment to: Amanda Hoey, EWGA Headquarters 300 Avenue of the Champions Suite 140, Palm Beach Gardens, FL 33418-3615 Phone: (800) 407-1477 Ext 12. Fax: (561) 691-0012 or [email protected]
