35th Eastern Regional Amputee & Disabled Golf Championship

35th EAGA Eastern Regional Amputee & Disabled Golf Championships

CHAMPIONSHIP ENTRY FORM

Tournament - August 7th, 8th, & 9th, 2022

Scramble - Sunday, August 7th, 2022

Penn State University Golf Courses, State College, PA

Registration Deadline is July 15th, 2022
Player Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse / Guest(s)
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Birthdate

MonthDayYear
Date
USAGA Sport Classification
Amputation
Other Disabilities
GHIN Handicap (or average score for 18 holes) *
Guest(s) GHIN Handicap (or average score 18 holes)
Flight Division?*
Will you be a Full Tournament or Scramble ONLY Participant or Both ?*
Requested Partner(s) for Sunday Scramble
EAGA Member ?*
EAGA Membership Type*
Comment or Requests:
Veteran
Branch
Rank
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
Tournament Fees:
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Sunday Scramble Event (ONLY) Fee for EAGA Member (Amputee or Associate)
Sunday August 7th (only). Includes: Green fees / 1/2 Cart / Deluxe Box Lunch / Sunday BBQ / Awards / Prizes / Hospitality

$135.00 Quantity
Item subtotal:$0.00



Sunday Scramble Event (ONLY) Fee for Non - Amputee Guest
Sunday August 7th (only). Includes: Green fees / 1/2 Cart / Deluxe Box Lunch / Sunday BBQ / Awards / Prizes / Hospitality

$150.00 Quantity
Item subtotal:$0.00



Sunday - Dinner Meal Fee per Non-Golfing Guest (Optional)
Sunday, August 7th

$38.00 Quantity
Item subtotal:$0.00



Tournament Entry Fee for EAGA Member (Amputee or Associate Participant)
Monday, August 8th and Tuesday, 9th. Includes: Green fees / 1/2 Cart / Monday Buffett Dinner / Tuesday Awards BBQ / Prizes / Hospitality

$210.00 Quantity
Item subtotal:$0.00



Tournament Entry Fee for Non - Amputee Guest
Monday, August 8th and Tuesday, 9th. Includes: Green fees / 1/2 Cart / Monday Buffett Dinner / Tuesday Awards BBQ / Prizes / Hospitality

$225.00 Quantity
Item subtotal:$0.00



Tournament Entry Fee for Monday ONLY
Monday, August 8th. Includes: Green fees / 1/2 Cart / Monday Buffett Dinner

$100.00 Quantity
Item subtotal:$0.00



Tournament Entry Fee for Tuesday ONLY
Tuesday, August 9th. Includes: Green fees / 1/2 Cart / Tuesday Award Buffet / Prizes / Hospitality

$100.00 Quantity
Item subtotal:$0.00



Monday - Buffet Dinner Fee per Non-Golfing Guest (Optional)
Monday, August 8th

$45.00 Quantity
Item subtotal:$0.00



Tuesday - Awards Dinner Fee per Non-Golfing Guest (Optional)
Tuesday, August 9th

$20.00 Quantity
Item subtotal:$0.00



EAGA Amputee Membership
Must be a 2022 Paid Amputee Member to participate in Eastern Regional

$15.00



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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