Official State Application
State Tournament June 27-28, 2011
Bridger Creek Golf Course
Bozeman, MT
APPLICANT INFORMATION
Player’s Name___________________________________________
Age (Prior 8/4/2011)_____________________________________________________________
Male/Female_____________ Date of Birth____/____/____
Players Email___________________________________________________________________
Average 18 Hole Score or Handicap_________________________________________________
Parent or Guardian’s Name________________________________________________________
Home Address___________________________________________________________________
City________________ State _____ Zip _________ Phone (
)__________________________
AMATEUR STATUS: The participant must be familiar with the USGA Rules of Amateur
Status and I have conformed to these rules in every respect. Participant must understand
the Championship and Qualifying event regulations and agree that this entry is subject to the
approval or rejection at any time by the Big “I” Officials at their discretion. I understand
that the use of alcohol, drugs or misconduct may disqualify me.
ELIGIBILITY: Boys & Girls who have not reached their 19th birthday prior to August 4,
2011. I understand the Eligibility and Amateur Status regulations as stated above.
Signature of Applicant_____________________________ Date ________________________
APPROVAL AND CONSENT BY PARENT OR GUARDIAN: As a parent or guardian of
the applicant, I hereby certify the facts as stated in the entry form and attest that I am
familiar with his/her plans to participate and that he/she does so with my approval. I further
certify in the event that emergency medical care needs to be administered to the above
named applicant, and the below mentioned person cannot be contacted, the required
parental consent may be given by an authorized member of the Tournament Committee.
Signature of Parent or Guardian________________________________Date_____________
In the event of an emergency contact:
Name_____________________________________________ Phone (
)______________________
Name_____________________________________________ Phone (
)______________________
NUMBER OF PARENTS ATTENDING THE BANQUET ON WEDNESDAY EVENING (maximum of 2 at no
charge:
Monday/Tuesday June 27-28, 2011:
Bridger Creek Golf Course, Bozeman, MT
Sponsored By:
The Independent Insurance Agents of Montana in conjunction
with the Montana Young Agents Committee
Open To:
Boys and girls who have not reached their 19th birthday prior to
August 4, 2011.
Entry Fee:
$75.00 per player-includes two rounds of golf; lunch both days;
Tee Prize and banquet on Wednesday evening for competitors
Please make checks payable to IIAM (Independent Insurance
Agents of Montana). Mail entries to First West, Inc. Attn: Bryan
Hall, PO Box 1800, Bozeman, MT 59771
Divisions:
BOYS
GIRLS
Ages 13 and under
Ages 13-15
Ages 16-18
Ages 13 and under
Ages 14-18
 All age groups will play 18 holes. National Qualifiers must play
from Tournament Championship Tees.
 Awards for the top three participants in each division
 Lunch provided after the completion of both rounds
 Banquet on Wednesday evening at 5:30. Up to two parents or
chaperones are welcome at no charge. At 6:30 we will have our
Skills Challenge on the driving range and putting green for a
chance to win some prizes.
 Special Room Rate of $89.00 + Tax at Comfort Inn Of Bozeman,
1370 North 7th Ave, Bozeman, MT 59715; 406-587-2322 Call for
reservations.
ALL ENTRIES MUST BE RECEIVED WITH PAYMENT TO THE PO BOX NO
LATER THAN 5:00PM ON JUNE 24th; THE TOURNAMENT COMMITTEE IS
NOT RESPONSIBLE FOR LATE MAIL. ENTRIES WILL NOT BE
ACCEPTED AT BRIDGER CREEK GOLF COURSE.
NATIONAL TOURNAMENT INFORMATION:
The Top 2 Boys Overall and Top 1 Girl will advance to the 43rd Trusted Choice Big “I” National Championship at
Reunion Golf & Country Club, Madison, Mississippi. August 1-4, 2011.
A natural environment tailor made for fine golf. Reunion is located in the beautiful, gently rolling hills of Madison,
Mississippi, and is the centerpiece of a master planned community. The championship quality 18-hole Course was
created by legendary designer Bob Cupp, who used his expert talents to make the most of every inch of the ourse's
length. Located on the historic Annandale Plantation, you'll find this course to be one of the most intertwined with
nature you'll ever see--with the occasional deer or turkey popping in to check out your game.