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The 2015 Johnnie Walker St. Kitts Open
A Royal St. Kitts Golf Club Event
@ the Royal St. Kitts Golf Course, Frigate Bay, St. Kitts
May 23rd & 24th 2015
APPLICATION FOR ENTRY – FEE US$275 FOR NON MEMBERS, US$225 FOR MEMBERS AND JUNIORS
To Register, FAX this form to the attention of the “Golf Shop” at Royal St. Kitts Golf Club @ 1-869-466-2701
Or Call Royal St. Kitts Golf Club at 1-869-466-2700 or mail this form to :
Royal St. Kitts Golf Club, P.O. Box 858, Basseterre, St. Kitts, West Indies
Name ………………………………………………………………………………………………………………………………….............
(FIRST)
(LAST)
Personal address for receipt …………………………………………………………………………………………………………………….
City ………………………………………………………………………. State ………………… Postal code………………………………..
Country ………………………………………………… Tel (H) (……..) ……….. - ……………… Fax (……..) ……….. - …………………
Email …………………………………………………………………………………..………………………………………………………………
Date of Birth(Age = Division): Month …………………… Day ……………………….. Year …………………….... Age …………..
Please list the country that you w ould like to have appear by your name in the pairings (if different than mailing address above).
Town/City ……………………………………………………….. State/Country …………………………………………………………………
If payment is by Credit Card, Please fill out the information below. I authorize the Royal St. Kitts Golf Club to charge my above credit card in US Dollars in the amount
of US$275(non member) or US$225(member) to pay my entry fees, per player for the 2015 St. Kitts Open Golf Tournament in St. Kitts on May 23rd – 24th.
Credit Card #: …………………………………....……… Expiration Date:.........................................................
VISA:
Mastercard:
AMEX:
Name on Card (please print): …………………………………....……….....................................................................................
Cardholder’s Signature: ………………………….................………..............................………..................
VERIFICATION OF HANDICAP
My current USGA Handicap Index of
and may be verified by:
_
_.
_
is on record at …………………………………………………………………..
(Name of golf association or club issuing handicap)
Name ………………………………………………….. Title …………………………………. Phone ……………………..……………………
(Handicap must be verified by an OFFI CER of named association or club and/or, HANDI CAP CHAIRMAN)
FLIGHT FOR WHICH YOU WILL BE QUALIFIED
(According to adjusted Handicap)
Championship
Men’s (10-24)
Senior’s(Over 50)
Super Senior’s(Over 60)
Ladies (0-36)
By submission of this entry I agree to the following:
I agree to all tournament rules and regulations. I have noted the requirements for notice of withdrawal, and registration.
I agree that there are certain risks inherent in the game of golf and accept personal and sole liability for all such risks.
I agree that this entry is subject to rejection at any time (including during the tournament) by the RSKGC. The reason for rejection may include unbecoming
conduct. Cancellation of entry must be done on or before May 10th, 2015 to be eligible for a full refund of entry fee.
SIGNATURE OF APPLICANT ……………………………………… ………………………………….. DATE ………………………………… ………..