Website: www.georgechiugolfclassic.com

The 10th Annual George Chiu Golf Classic
Amateur Chinese Golf Tournament
Lionhead Golf and Country Club
July 6th and 7th, 2019

ENTRY FORM
Please use a separate registration form for each player. Photocopies are acceptable.
Online registration is available at www.georgechiugolfclassic.com
Registration opens on May 11, 2019. 
Player Entry Fee ON OR BEFORE MAY 18, 2019: CDN $175.00. Seniors 65 and older CDN $135.00 (Early Bird Special).
Player Entry Fee AFTER MAY 18, 2019: CDN $195.00. Seniors 65 and older CDN $150.00.
Junior Players Ages 8 to16 with a Handicap index of 25 or less are Invited to Play Free of Charge.
The field is limited to 168 golfers including 40 junior players (20 boys and 20 girls) on a first come, first served basis.

The entry fee includes green fees, power cart (for players only), breakfast, lunch, welcome package, awards dinner on July 7th, 2019 and lucky draw prizes. Additional dinner tickets for guests are available at CDN $50.00 each.

Name:
Gender:
Age: 
Home
Address:
City:
Province
/State:
Postal/ZIP Code:
Telephone:
Email:
Club Affiliation (if any):
Handicap Index:
Please check the appropriate category:
Cancellation Policy: Any cancellations before June 15th will be entitled to a refund less 20% administration fee.
    After June 15th, there will be NO refunds.
Total Payment: 
(As of July 6th, 2019) 
Payment Method:

Full Name on Credit Card:

   (16 digits) Credit Card #

(ie. 01/15) Expiry Date:

(3 or 4 digits) Check Digits:

Billing Address of Credit Card

Address:

City:

Province/State:

Postal Code/Zip Code:
Terms and Conditions

By pressing "I Accept the Terms and Conditions" button below or signing this form, you agree to the following:

i) I will abide by the GCGC Tournament Rules and Regulations

ii) I have provided correct and accurate Personal and Billing information above


I, the undersigned, hereby waive, release and hold harmless the George Chiu Golf Classic Tournament, its executives, committee members, volunteer, employees, as well as the Lionhead Golf and Country Club and its employees from any liability resulting from injury or loss through my participation in this event. 
 
I hereby give my permission to allow my name, photographs and tournament results to be released to the press/media and allow this information to be posted on the official George Chiu Golf Classic website including any articles resulting in my success.

By clicking "I Accept the Terms and Conditions" or signing this Entry Form, I do acknowledge that I have read, understand and will abide by the Tournament Rules and Regulations of the George Chiu Classic.

If sending by mail, please make Cheque/Money Order payable to: George Chiu Golf Classic
Mailing Address:
George Chiu Golf Classic
4295 Lee  Drive, Mississauga, Ontario, Canada  L4W 4A2

© Copyright 2013. George Chiu Golf Classic Inc.  All rights reserved.  
Signature:______________________________
MaleFemale
Championship Division "A" Division "B" Division Senior Division Ladies Division
Regular Player CDN $195.00 Senior Player CDN $150.00
Extra Dinner Ticket: CDN $50.00N/A
Visa Master Card AmexCheque/Money Order