Entry Form

THE PRESERVE OPEN
GREATEST DAY IN GOLF
BROUGHT TO YOU BY
THURSDAY, JUNE 18, 2015
All entries are on a first come, first served basis
ALL players may enter on-line at www.thepreserveopen.com. Completely executed entry must be received at the following address:
ATTN: THE PRESERVE PAR 3 CHAMPIONSHIP ENTRIES
THE PRESERVE AT BOULDER HILLS
87 KINGSTOWN ROAD
WYOMING, RI 02898
Entry Fee for Qualifier (Circle One):
PGA Professional: $250 Amateur: $250 Non-PGA Professional: $250
Name: _________________________________ PGA Member #: ____________________
Facility: _______________________________ Email Address: _____________________
Preferred Mailing Address: ____________________________________________________
Daytime Phone: _______________________
Evening Phone: ______________________
Social Sec# (required): _________________
Date of Birth: _______________________
Credit Card Information (please circle):
AMEX
MasterCard
Visa
Card Number: _________________________________
Expiration Date: ____________
Name on Card: _________________________________
Verification Code: __________
Billing Address: _____________________________________________________________
PLEASE FAX THIS ENTRY FORM TO 401-439-4655
Signature ____________________________________________________________________________________
FOR OFFICE USE ONLY
Date Entry Received ……………….. Received by ………………..Check # ……………….. Amount: …………….
Monday, May 18
Wednesday, May 20
Tuesday, May 26
Thursday, May 28
Sunday, May 31
Qualifying Dates:
Tee Times Begin at 7:30am
Tee Times Begin at 7:30am
Tee Times Begin at 7:30am
Tee Times Begin at 7:30am
Tee Times Begin at 7:30am
Visit www.thepreserveopen.com to register for a Qualifier
Qualifying
Those players not exempt from the Championship (see below for exemptions) are subject to qualifying. Five
Qualifiers will be held at The Preserve at Boulder Hills (see below for dates) and are open to ALL male and
female Professionals or Amateurs with no handicap required. Amateurs will be competing for a $10,000 hole-­‐in-­‐one prize on every par 3 during the qualifiers. Players must pay the $250
qualifying fee. Players successfully qualifying will need to pay an additional fee as follows for the
Championship Finals.
Amateurs - $100, PGA Professionals - $200, Non PGA Professionals - $400
For specific qualifying details, please visit the respective registration pages. Players may attempt to qualify
more than once if unsuccessful (based upon availability), but another entry fee plus $100 will be charged. Cart
fees are included in your entry fee for the qualifying and the tournament proper.
Qualifying Dates:
Monday, May 18
Tee Times Begin at 7:30am
Wednesday, May 20
Tee Times Begin at 7:30am
Tuesday, May 26
Tee Times Begin at 7:30am
Thursday, May 28
Tee Times Begin at 7:30am
Sunday, May 31
Tee Times Begin at 7:30am
Visit www.thepreserveopen.com to register for a Qualifier
Eligibility
Entries are open to ALL PGA Members and Apprentices, Non-PGA Professionals and Amateur golfers with no
handicap limitations. PGA Members and Apprentices must be eligibly employed and in good standing with the
PGA of America as of the stated entry deadline, AND the Championship proper. Entries are subject to
rejection at any time (including during the Championship) by the NEPGA. The reason for rejection may include
unbecoming conduct. Amateur Status: All amateurs must conform to the USGA Rules of Amateur Status as
specified in the USGA Rules of Golf.
Exemptions
Entry Fee is as follows:
Amateurs - $350, PGA Professionals - $450, Non PGA Professionals $650
2015 The Preserve Par 3 Championship Exemptions
PGA of America Section Champions in 2014
Top 5 – Amateurs in World Rankings as of March 1, 2015
Top 5 - NEPGA Wogan Player of the Year Points System 2014
Top 5 - RIGA Player of the Year Points System 2014
RI, MA, VT, NH, ME, CT, NY and NJ State Women’s and Men’s Open Champions 2014
RI, MA, VT, NH, ME, CT, NY and NJ State Women’s and Men’s Amateur Champions 2014
RI, MA, VT, NH, ME, CT, NY and NJ Women’s and Men’s Amateur Players of the Year 2014
Women’s NE Open Champion 2014
Women’s Teaching and Coaching Northeast Champion
Women’s Teaching and Coaching National Champion
Entries: Fee, Closing Date
The applicable fee listed on the entry application shall be paid by every player. The entry fee will be refunded
for any reason if the NEPGA is notified in writing before the close of entries. After close of entries, entry fee will
be refunded in the event of injury or illness, if requested in writing. A $25 service charge will be deducted from
all refunds.
All player entries must be received at the The Preserve at Boulder Hills office or processed on-line no later
than 5:00 PM (EST) on Wednesday, May 10th.
Applications available on-line at
www.thepreserveopen.com. Applications late or incomplete are not acceptable. Starting times will be
published at www.thepreserveopen.com and at www.nepga.com 5 days prior to the event.
Championship Schedule
Thursday, June 18th, 2015 – The Preserve at Boulder Hills
18 Holes, Individual Stroke Play
Low scorer for 18 holes will be declared the champion. In the event of a tie for the championship, there will be
a hole-by-hole playoff immediately following completion of play. The NEPGA reserves the right to change the
format and schedule from that presently contemplated.
Prizes
Championship: Professional Purse: $100,000. Top 40 Professionals will receive payout from Championship
purse. The Championship will also feature 18 Hole-In-One Prizes given to the first amateur player who records
a Hole-In-One on each hole. $10,000 during the qualifier and $1,000,000 during the Finals. The top 10
amateurs will be paid out. Low Amateurs will receive a low am trophy as well as $750 in pro shop credit, while
the remaining top 9 will receive a payout in merchandise credits at The Preserve.
Practice Rounds
Practice rounds for the Championship Proper will be available on a limited basis. You may qualify now thru
May 30th. The course will be closed May 31 – June 18, so please schedule a practice round early. Contact the
golf shop to schedule a tee time at 401-539-4653. Carts are mandatory for all practice rounds and all
participants will be charged a rate of $50 per practice round. No caddies will be allowed. Only those players
registered into the Championship will be allowed practice rounds at the Championship site.
Conditions; Schedules
The NEPGA Tournament Committee reserves the right to alter any of the conditions and schedules herein.
The decision of the Tournament Committee in any matter shall be final.
Personal Appearance
In qualifying and the Championship proper players must be neat in appearance with respect to clothing and
personal grooming. Professionals are required to wear pants during qualifying and Championship proper. The
wearing of short pants will be prohibited for all players at Championship proper.
Contact
Please contact The Preserve at 401-539-4653 or the NEPGA at 508.869.0000 with any questions.
RELEASE AND WAIVER OF LIABILITY
ASSUMPTION OF RISK
In consideration of the use of a golf carts and other equipment including (referred to individually and
collectively as “other equipment”), but not limited to, mountain bikes and ATVs, at The Preserve at Boulder
Hills, the undersigned, being 21 years of age or older, for himself/herself and personal representatives,
heirs, and next of kin does hereby:
1.
Release, waive and forever discharge The Preserve at Boulder Hills, LLC; Preserve
Management, LLC; and their (or either of their) assigns, agents, successors, and all affiliated
companies together with their respective officers, directors, members, shareholders, members,
employees, representatives, agents, successors or assigns (referred to individually and collectively as
"Releasees") from any and all liability to the undersigned, his/her personal representatives, assigns,
heirs, and next of kin for all losses or damages and all related claims, on account of injury to the person
or property, or resulting in the death of the-undersigned which arise from or relate in any way to the
undersigned's use of the golf cart, or other equipment, however caused and whether caused by the
negligence of the Releasees or otherwise.
2.
Covenant and agree that the undersigned shall not commence or maintain any suit thereon
against Releasees and agrees to indemnify, save and hold harmless Releasees from and against any
and all loss, liability, damage or cost incurred which arise or relate in any way to the undersigned's use
of the golf cart, or other equipment, whether caused by the negligence of Releasees or otherwise.
Agree to indemnify Releasees from any and all liability arising from the use of the golf cart, or other
equipment.
3.
Assume full responsibility for any risk of bodily injury, including death, or property damage
arising out of or related in any way to the undersigned's use of the golf cart, or other equipment, whether
caused by the negligence of Releasees or otherwise. Agree to defend Releasees against lawsuit arising
our of the use of the golf cart, or other equipment.
4.
Acknowledge that the use of the golf cart, or other equipment, involves risk of serious bodily
injury, including death, and property damage. In the event of accident, the undersigned expressly
acknowledges that his/her injuries may be compounded or increased by negligent rescue operations or
procedures of Releasees, and does hereby knowingly and expressly forever release and discharge
Releasees from all claims arising therefrom.
5.
Agree that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement
extends to all acts and omissions, including negligence, of the Releasees, including but not limited to,
negligent rescue operations, and is intended to be as broad and inclusive as is permitted by the laws of
the State of Rhode Island. The undersigned further agrees that if any portion hereof is held invalid, it is
agreed that the remaining terms shall, notwithstanding, continue in full legal force and effect.
I have read this complete release and waiver of liability, assumption of risk and indemnity agreement, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT,
ASSURANCE OR GUARANTEE BEING MADE TO ME. I further intend my signature to constitute a
complete and unconditional release of all liability to the greatest extent allowed by law.
Signature
_________________________
Name
_________________________
Date
_________________________
This form, in addition to the application, must be sent in to be officially signed up if faxed or emailed.