Closing date for entries June 1st, 2019: Must be postmarked no later than June 1st, 2019 or a $25 late fee must be included

(Please complete this form online)

  Title:     First Name:     Last Name:  

Age:  

Address  

Check One (play)

City  

    Open

Country  

    Senior  ( 55 years old and up)

State  

     Super Senior  ( 70 years old and up)

Zip Code  

    Women

  E Mail Address            Note: Your email address must be valid. Otherwise your    application will   be rejected.    Phone () - -                      VP   Text    

EMERGENCY
CONTACT

Contact Name:  

  

Relationship:  

  

Phone   

 () - -  VP   Text  VRS  

E mail:  

  

Pager:  

  

   Average Golf Score: 

  Handicap ?  Yes   No     *(See below)

   Hall of Fame Member: Yes   No
   How many Banquet tickets for you and your guests?  
   
   Officer of SEDGA      Yes    No

Entry Fees:  Open - $255    /    Seniors - $255

  

*Optional Fees: Banquet per Person - $40   /    Handicap Tournament - $20

  Golf Club?  
Please return the entry form, check or money order to:


Chester Kuschmider

9541 Hyde Pl

Frederick, MD 21704

 

Make payable to SEDGA 2019

Your entry form is not valid without an

appropriate check or money order

Do not type in the boxes below.   Just click Calculate Total Cost only.    

   Entry Fee ($255/$255 Senior):

   *Banquet for you and guests ($40):Optional:

   *Handicap Tournament: ($20) Optional:

   Late Fee: ($25):

        Grand Total  

Handicap -- To participate in the handicap tournament, you MUST meet one of the following requirements:
Played in at least one regional tournament in the past 5 years OR
Member of a state Deaf golf association that can provide a handicap index OR
USGA Handicap index card.
    
   

               

Please wait patiently after you click "SUBMIT" to allow sufficient time for the information to be processed.  Please do not double-click.  Thank you. 

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