GM NATIONAL JUNIOR GOLF TOUR

PORTAL CHAMPIONSHIP
IMG Q-2 and IMG ACADEMY JUNIOR WORLD CHAMPIONSHIPS December 2016

1ST October 2016


All age divisions in this event will play 18 holes

APPLICATION FORM

Player's Name: ______

Male (M) / Female (F): ______Date of Birth (DD/M/YR): ______/______/______

Handicap or Score Average ______(Proof may be required at check for the tournament)

GM NATIONAL UK TOUR RULES APPLY TO THIS EVENT – please consult these before sending your application

Address: ______


______

City: ______County/State:______

Postcode/Zip: ______Country:______

E-mail address: ______

Tel No (Inc International Dialling Code): ______

Parent(s) / Guardian(s) name(s): ______

______

Relationship to Participant: ______

ENTRY FEES

GM TOUR MEMBERS £50 FOR THE EVENT (All divisions play 18 holes)

NON GM TOUR MEMBERS £60 FOR THE EVENT (All divisions play 18 holes)

ENTRY DEADLINE 26th September 2016

All Cheques must be: Account Payee and in Pounds Sterling from a UK bank

All Cheques to be made payable to: Graham Moore Golf Tour Ltd

All direct bank payments must be drafted in POUNDS STERLING AND ANY COSTS BOTH SENDING AND RECEIVING BY GM GOLF TOUR Ltd. MUST BE PAID BY THE AGENT OR INDIVIDUAL ISSUING THE TRANSACTION & NOT GRAHAM MOORE GOLF TOUR Ltd to

Bank Account No: 67157874 Sort Code (Routing No) 60-15-29 / IBAN GB85 NWBK 6015 2967 1578 74

You can also use our on Online Payment Page (World Pay secure online).
You can also use our on Online Payment Page (World Pay secure online).

Bank Address: National Westminster Bank

The Bull Ring

Northwich

Cheshire

England[

UK
CW9 5BW

Graham Moore Golf Tour Ltd (Incorporating Graham Moore Junior Golf Tour) is a private Limited Company
registered in England & Wales Company number 5759783
Copyright © 2004 – 2016 All rights reserved

Disclaimer

On behalf of Participant (Name): ______in the Graham Moore International Junior Golf Tour (G.M.I.J.G.T.). I/We the undersigned acknowledge and agree to waiver any responsibility of Graham Moore Golf Tour Ltd, Sponsors, Officials, Directors, Staff and Volunteers from any event and/or consequence that could or has led to any damage or injury to the above named participant and/or their equipment and belongings.

I/We also agree by signing this disclaimer not to seek legal recourse (either individually or as part of a group) against Graham Moore Golf Tour Ltd, its Sponsors, Officials, Directors, Staff and Volunteers, in respect of refunds of money for non participation as laid out in the Rules and Regulations of the Tour.

I/We also agree to allow qualified medical personnel to take all necessary measures to treat the above named participant due to illness or injury resulting from the individual’s involvement in Graham Moore Golf Tour Ltd activities.

I/We the undersigned will insure myself/ourselves to cover in case of these situations arising. Also I/We will ensure that I/We will provide adequate travel insurance cover where necessary.

Graham Moore Golf Tour Ltd also reserve the right to promote Graham Moore Golf Tour Ltd activities throughout the calendar year, using the participants of the Tour, and by signing this disclaimer I/We agree to the use of the above named participant and his/her likeness in any such promotion.

SIGNED: ______DATE (DD/M/YR): ______

NAME (PRINTED)______

RELATIONSHIP TO PLAYER: ______

SIGNED: ______DATE (DD/M/YR): ______

NAME (PRINTED)______

RELATIONSHIP TO PLAYER: ______

Player's Aged 18 or older must complete this form themselves.

Player's under 18 years of age must have parent(s)/Guardian(s) signature.


GM NATIONAL JUNIOR GOLF TOUR

NON MEMBERS RESUME / HISTORY

Players who have never played with GM NATIONAL JUNIOR TOUR in the past are required to complete the below resume

Seven Best Tournament Scores

DATE OF THE EVENT / SCORE / PAR / HOLES / TOTAL YARDAGE / GOLF ASSOCIATION / CLUB
1
2
3
4
5
6
7
ANY OTHER INFORMATION YOU THINK IS RELEVANT TO US