Men and Ladies - Great Lakes Amateur and Tuncurry Seniors
Which events are you entering? *
Required
Are you a Vardon or Jean Derrin registered player (for Saturdays event)
Captionless Image
Your answer
Nominate the players you want to play with on Sunday
Your answer
Nominate the players you want to play with on Monday
Your answer
Your Surname *
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Your first name *
Your answer
*
Birth Date
Required for the Monday Seniors event only.
Your answer
Phone / Mobile *
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email
(you will be emailed a conformation)
Your answer
Golflink No. *
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GA Handicap *
Your answer
Total of your entry fees $ *
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Pay by: *
Credit Card Number
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Expiry Date _ _ / _ _
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CCV
This is the 3 digit number on the back of your card
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Cardholders Name
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