22nd ANNUAL TRI-STATE PGA

NIKE GOLF LAS VEGAS PRO-4 AM

OCTOBER 17 – OCTOBER 22, 2015

Trip Includes:

· 6 days / 5 nights accommodations at Planet Hollywood Resort and Casino

· 3-day Pro-Am Golf Tournament with a maximum of 66 TEAMS OF FIVE PLAYERS

· Monday – Exclusive use of all THREE Paiute Resort Courses, 9:00 AM shotgun start

· Tuesday – Exclusive use of all THREE Paiute Resort Courses, 9:00 AM shotgun start

· Wednesday – Exclusive use of all THREE Paiute Resort Courses, 9:00 AM shotgun start

· New and exciting tournament each day on both courses

· Skins game & Pari-Mutual Betting available

· All Amateur’s MUST have a current verifiable handicap index

Total price of trip per amateur $1,425.00 (Price based on double occupancy)

Team Deposit - $1,200 ($300 per amateur) to hold your spot!

**You may charge the deposit to more than one credit card** Please make copies of this form!

First team Deposit of $600 due 2/28/2015…Second team deposit of $600 due 4/30/2015

IMPORTANT: Team Deposits needed to hold Hotel Block and three courses at the Paiute Golf Resort

Final payment per amateur $1,125.00 Final payment due 7/15/2015

Non Golfer or Single Supplement Price $350.00

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2015 TRI-STATE PGA NIKE GOLF LAS VEGAS PRO-AM

Reservation / Deposit Form

PGA Professional: Member #:

Club:

Type of Payment: MasterCard Visa Check (Circle One)

Non-Refundable Team Deposit: Total Amount Enclosed: $ Check #

(First team Deposit of $600 due 2/28/2015…Second team deposit of $600 due 4/30/2015)

CREDIT CARD USE ONLY

Name As It Appears On Card:

Credit Card #: Exp. Date: Security Code ______

Address credit card bill come to: ______

City, State, Zip:

Signature:

(PAYMENT MUST ACCOMPANY ENTRY FORM)

Please Make Check Payable To: Tri-State PGA – 221 Sherwood Drive – Monaca, PA 15061

(Credit Card Payments may be faxed to 724/774-5535)

**If you are charging the deposit to more than one credit card, please make copies of this form**