Entry Form

Charles Blair Macdonald Challenge and
Eastern Canadian Hickory Championship

NAME: ___________________________________________________________________________

ADRESS: _________________________________________________________________________

E-MAIL: __________________________________________________________________________

DIVISION: (please choose one of the four)

OPEN / SENIOR (over sixty) / SUPER SENIOR (over seventy) / LADIES

HANDICAP: SoHG HICKORY _____ or MODERN (if you have no hickory handicap) ____

COST(includes practice round ): $270.00 (limited field – entries close May 1, 2014)

EXTRA MEALS for Guest(s) (at $25 per meal)
– for Saturday________________
– for Sunday _________________

– Post 1900 set – $25.00 per set _______________

– Pre-1900 set – $35.00 per set ________________
(Please include payment with entry form)

Send entry with cheque payable to Paul Dietz to :

Paul Dietz

509 Hedden Court

Sarnia, Ontario, Canada

N7S 6L8

Note: participants withdrawing from the event have two options (a) their entry fee minus 15% returned to them OR (b) entire entry fee applied to the following year's event.

Entries not accepted without accompanying entry fee – Cheques may be post-dated to May 1, 2014.

Questions? Please contact Paul Dietz at 519-331-6585 or at clubdoc1@gmail.com