Registration for the 2019 Southwestern Ontario Qualifier
LATE REGISTRATIONS ARE UP TO THE DISCRETION OF LOCAL TOURNAMENT CHAIRMAN. Registration is subject to availability.

REGISTRATION FEE: $65.00.

Online registration does NOT include payment. After submitting your online registration, Pay by Paypal at https://sites.google.com/site/swontoptimistgolf/

or make Check payable to Essex Youth Center - Golf and mail payment to

Essex Recreation Complex
242 Talbot St N, Lower Level, Rear Entrance
Essex, ON N8M 2E1 Canada


Your registration will not be considered complete until payment is received
First Name *
Your answer
Last Name *
Your answer
Birthdate *
(MM/DD/YY)
Your answer
Mailing Address *
Your answer
City *
Your answer
Province *
Your answer
Postal Code *
Your answer
Parent's Name(s) *
Your answer
Home Phone *
Your answer
Parent Cell/ Work Phone *
Your answer
E-mail Address *
E-mail is the main method of communication. Please enter your e-mail address carefully.
Your answer
Age Division *
Division determined by golfer's age on August 19, 2019
Player Certification *
By clicking "YES," I certify that I am an amateur player, according to the rules of the U.S. Golf Association, and that the information on this application is true to the best of my knowledge.
Required
Parent Certification *
In consideration of the privilege of my child’s participation in the qualifying for the Optimist Championship, I herby release the sponsor from any and all liability resulting from any accidents that might occur while he/she is participating and recognize that pictures may be used by the sponsor.
Required
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