2023 International Golf Registration

 
OFFICIAL ENTRY FORM FOR THE
2023 INTERNATIONAL STATE EAGLES POOL TOURNAMENT
Aerie #1834 – Columbus NE    October  13 –15, 2023
Held at Aerie Home – 3205 12th St.
 
AERIE NAME AND NUMBER:                               TEAM NAME:
 
_______________________#_________                  ___________________________________
 
NAME OF TEAM CAPTAIN:                                   PHONE
 
________________________________                    ___________________________________
 
ADDRESS OF TEAM CAPTAIN:
 
Street:                                                             City:                                State:            Zip:

 
Email address of Captain : ____________________________________
 
All team members must be in good standing and have current paid MMS receipt . Players without receipts will not be eligible to play.  Aerie per capita tax needs to be paid in order to be eligible for prizes.  Any team found using illegal players will forfeit all games.   THERE WILL BE NO EXCEPTIONS.
 
Please list PRINT OR TYPE  names below, as they would be paired.
 
A) ________________________________               AA) ________________________________
            GAID#____________                                                GAID#____________
 
H)_________________________________              HH) _________________________________
            GAID#____________                                                GAID#____________
 
CLUB SECRETARY  needs to verify players are in good standing
                        SECRETARY SIGNATURE _____________________________________
 

• Make checks payable to:  Columbus Eagles Club
• Send this completed entry form and $300 entry fee to Box 1336 Columbus NE 68601                    ATTN:Dennis Micek
• First 40 teams  paid entries will be accepted!  (Date determined by postmark)
• For further information  Dennis Micek (402) 276-2603 email dmicek@eaglecom.net or

  or Doug Wiese (402) 910-8233 email dwiese@ernstauto.com

• Returned checks will carry a $30 fee and may cause team to not be entered.

 

• NO entries accepted via email!                NO Refunds

 

• MUST have been an Eagle Member for at least 6 months prior to the Tournament-GRAND AERIE RULE