14^th FATHER-DAUGHTER CHAMPIONSHIP

Thursday August 13, 2009

INTERVALE COUNTRY CLUB – MANCHESTER, NH

Enclose entry fee of $50 payable to NHGA

Send payment to:

New Hampshire Golf Association, P.O. Box 486, Wolfeboro, NH 03894

Please print and complete every blank

NAME (FATHER)____________________________________________________

GHIN NUMBER (NOT HANDICAP INDEX) ____________________________

ADDRESS ____________________________________________PHONE ____________________

CITY ______________________________________STATE _______ ZIP __________________

EMAIL ADDRESS __________________________________

CLUB _____________________________________________________

NAME (DAUGHTER) __________________________________

DATE OF BIRTH ___________________ AGE (as of August 13) ____________________

GHIN NUMBER (NOT HANDICAP INDEX) ____________________________

___ I WILL WANT A CART

___ I DO NOT WANT MY PICTURE ON THE WEB-SITE

I agree to the championship regulations on the pages of the application. I have read and understand the requirements of eligibility and for acceptance of this entry. I agree this entry is subject to approval or rejection at any time by the New Hampshire Golf Association at its discretion. All contestants must abide by the rules of the host club.

Signature of Applicant _______________________________________ Date ________________

Father Daughter