Please complete this registration form and email to
Mick Camfield at [email protected] or for
enquiries +61 418 956 344
Team Leader Name
Dress Standards
Golf:
Collared shirt tucked into tailored pants or
shorts, with golf shoes or soft rubber soled
shoes. No cargo, tracksuits or denim.
Dinner: Short or long sleeve buttoned shirt with hard
collar worn with tailored pants or neat denim
jeans and dress shoes.
GA Handicap
Company Name
Email Address
Payment Details
Cost per team $1,100
I would like to pay via EFT. Attached is a copy of the
payment confirmation. Easy Golf Event Perth Pty Ltd
BSB: 066153 Account No: 10670887
Team Members
Name 1
Email
GA Handicap
Visa Card
Or, please debit my: Master Card
(Sorry, we cannot process Diners Club and Amex cards)
Name 2
Email
/
GA Handicap
/
/
3 Digit Security Code
Name 3
Email
Expiry Date
GA Handicap
/
Amount $
Cardholder’s Name (as it appears on the card)
If you do not have an Official Club Handicap, please leave
the above fields blank and you will automatically play off
18 for men and 27 for ladies.
How many sets of hire clubs are required?
(Left or right handed) RH
LH
Dinner Attendance
Please indicate in the box, the number of your team
and partners attending the dinner (extra guest at
$125 each).
Dietary Requirements:
Signature
Unfortunately I am unable to attend this year but
would like to make a donation to Wheels for Hope.
$
WINNING TEAM PRIZE!
A TRIP FOR FOUR TO BALI
(Valued at $5000)
Wonderful Indonesia and Wheels for Hope would
gratefully like to acknowledge yours and the
sponsors support of this event.
4 Days / 3 Nights in a 5 star hotel (inc. breakfast)
1 round of golf per person and golf transfers.
(Airfares not included.)
HOLE IN
ONE PRIZE
A brand new Toyota C-HR
which is to be released
in Australia on
28 February 2017!
Proudly
Supporting
Picture for illustration purposes only.
Organised by