GCSAA 2009 Conference Brochure - (Page 80) GCSAA NATIONAL CHAMPIONSHIP AND GOLF CLASSIC GCSAA 2009 NATIONAL CHAMPIONSHIP & GOLF CLASSIC ENTRY DEADLINE: Monday, December 1, 2008, at 5 pm CST ■ Male ■ Female Member Number First Name Club/Firm Name Preferred Mailing Address (Street Address) ■ Home ■ Business City Country Code Fax Number State ZIP E-Mail Address (please print legibly) M Initial Member Class Last Name Nickname Check here and indicate any special ADA needs in a separate letter. ( ) ( ) ( ) Contact Phone Number Daytime Telephone Emergency Contact Name Personal Mobile Phone Number GCSAA OFFICE USE ONLY Commemorative Tee Prize Tournament Housing Camp Shirt ■ Small ■ Medium ■ Large ■ X-Large ■ XX-Large The Perdido Beach Resort will be the host hotel. Because competitors are not required to stay in the host hotel, GCSAA has secured a limited number of hotel rooms. First-come, first-served will apply, so register early to secure your hotel room. GCSAA reserves the right to place you in another hotel based on availability. Please complete the reservation requirements below with accuracy to avoid any delays in processing your request. If you plan to share a room with another participant, please verify this with your proposed roommate(s) before listing his/her name. Each person requesting a room reservation must complete this portion of the form and provide credit card information at the bottom of this form. This information will be provided to Golf Industry Travel. ROOM TYPE ■ Standard Queen: Double (2 people/2 beds) Triple (3 people/2 beds) Quads (4 people/2 beds) ■ Standard King: Single (1 person/1 bed) Double (2 people/1 bed) ■ Not staying at host hotel ROOM RATE $149 plus taxes per room PERSONAL INFORMATION Required for all reservations /2009 Arrival Date $149 plus taxes per room Sharing w/event participant (name) Sharing w/spouse or child (name) Departure Date /2009 Cancellations/Changes: Please do not be a “no-show.” Should you find you must change or cancel your plans to attend the 2009 event, contact Golf Industry Travel at 800.442.7220. All changes after December 18, 2008, will be subject to approval of the hotel. Entry Fees ■ 9101 National Championship Entry (Sunday, Feb. 1 – Tuesday, Feb. 3) Handicap must be 5.0 or less to be eligible Certification of Handicap $600 $450 GHIN Number or similar identification number Name of association issuing your handicap Web address to verify handicap Contact name to verify handicap Status: ■ Amateur ■ Pro Handicap information is mandatory. You must submit a copy of your current handicap card with your registration form. HANDICAP INDEX ■ 9201 Golf Classic (Monday, Feb. 2 – Tuesday, Feb. 3) OFFICE USE ONLY HDCP VERIFIED ■ Check here if you wish to play in one of the Senior Flights. Seniors: To be eligible to compete in a senior flight, you must be 50 by Jan. 28, 2009. DOB: / / ■ Senior I (age 50-56) ■ Senior II (age 57-64) ■ Super Senior (age 65+) ■ 9202 Four-Ball Mixer (Sunday, Feb. 1) Pair me randomly from the pool of players: ■ Yes ■ No, I have a partner Four-Ball Partner Name: You and your partner cannot exceed a combined handicap of 45. $150 DATE ■ 9103 Family/Guest (Number of tickets ) $100 each $ Family/Guest ticket includes Welcoming Reception, and three 19th Hole events. Family/guests ages 20 and younger admitted at no charge, but please include names for badges. Family/Guest Name: Family/Guest Name: Grand Total Owed: $ INTERNATIONAL COMPETITORS: Eligibility of an international player must be certified by the organization governing golf in his/her home country. All handicap indexes will be verified for flighting purposes approximately 60 days before the championship. FLIGHT INFORMATION: All flights will be determined based on competitor’s verified handicap index. Form of Payment Credit Card ■ MasterCard ■ Visa ■ American Express ■ Please use my credit card for room guarantee only. Check payment is enclosed for fees. ■ Please use my credit card for both room guarantee and payment of fees. Check (Payable to GCSAAU.S. dollars drawn on U.S. bank) Mail to: GCSAA Registration, P.O. Box 219004, Kansas City, MO, 64121-9004 Fax to: 785.832.3628 (don’t do both), with credit card payment information. Cancellation/Refund Policy All cancellation requests must be submitted in writing. Cancellations received before Monday, Dec. 1, 2008, will be honored for a full refund, less a $25 administration fee. After Monday, Dec. 1, 2008, the entry fee will be refunded in the event of injury or medical emergency, if requested prior to the first day of competition. No refunds will be issued for any reason after the start of competition. - - - Expiration Date (MM/YYYY) Card Holder’s Signature Credit Card Number (AMEX will only be 15 digits) Card Holder’s Name (please print) GOLF Register at www.gcsaa.org/conference 77 http://www.gcsaa.org/conference http://gcsaa.org
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