Entry Form

Charles Blair Macdonald Challenge and
Eastern Canadian Hickory Championship

NAME: ___________________________________________________________________________

ADRESS: _________________________________________________________________________

E-MAIL: __________________________________________________________________________

Please indicate the division entered (Check one):
__ OPEN CHAMPIONSHIP ** (18 holes each day — Friday, Saturday and Sunday)
__ SENIOR CHAMPIONSHIP** (18 holes each day — Friday, Saturday and Sunday)
__ OPEN (59 and under) (18 holes each day — Saturday and Sunday)
__ SENIOR (60 to 69) (18 holes each day — Saturday and Sunday)
__ SUPER SENIOR (70 and older) (18 holes each day — Saturday and Sunday)
__ LADIES (18 holes each day — Saturday and Sunday)
** Championship divisions limited to first 20 players registered

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

COST (includes practise round): $275.00 (limited field – entries close May 1, 2015)
EXTRA MEALS for Guest(s): (at $25 per meal)
– for Saturday________________
– for Sunday _________________
RENTAL CLUBS:
– 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, 2015.

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