2022 Governor's Open entry form

Pro-AM September 9; Open September 10 & 11

Name:______________________________________
Address: ____________________________________
City________________________________________
State, & Zip: _________________________________
Phone (day):_________________________________
Phone (evening): ______________________________
E-mail add: __________________________________
Home Course: ________________________________
GHIN # for amateurs__________________
Payment Type:  Cash at Pro Shop  Check  Credit Card
Card number Visa or Mastercard: _________________________________ CVV number:________
Exp. Date____________________________________
Cardholder's Name: ____________________________
Cardholder's Signature: __________________________
Tax ID or Social Security Number (Professionals): _________________

OFFICIAL USE ONLY:  Entry #: _____ Check # ____ Amount: ________ Date: __________


Professional   Senior Professional (50+)
Amateur   Senior Amateur (60+)
All Events  Pro Am Only Open Only
Pro-Am Preference  AM  PM
Flexible?    Yes   No
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Entry deadline: Friday, September 2. Must be received by deadline, not by post mark, if mailed. We can not be responsible for postal service handling.)

(Check or credit card information) must be included with entry forms and payable to "JHGA".
Address must be same as credit card billing address.
Email with credit card to jhgagolf@gmail.com

Professional entry fee for Open and Pro-Am: $250.00
Professional entry fee for Pro-Am only: $100.00
Amateur entry fee for Open and Pro-Am: $200.00;
Amateur entry fee for Open only: $150.00;
Amateur entry fee for Pro-Am only: $75.00;

Mail entry form and fees to:
Juniper Hill Golf Association
P.O. Box 4232
Frankfort, KY 40604-4232
Please do not mail cash.

Email with credit card to: jhgagolf@gmail.com