Registration Form
You are registering for the Sat. Oct. 23rd, 2021 at Highland Falls Las Vegas tournament. The tournament fee for VIP members is $ 69 . The fee for non-members is $ 79 . Please make checks payable to Doug Jensen.
Player Information
First name:   
Last name:   
Address1:   
Address2:   
City:   
State:   
Zip code:   
Phone: ( )    -
Email:   
Name of
playing partner:
  
Handicap Index:   
  I am a current VIP Member
  I would like to purchase a VIP Membership.
  Please add the prorated annual fee to my tournament
  registration fee.
How did you hear about us?
Comments
I would like to receive my winnings as:
     

Note: VGA Bucks may be used for future tournaments or VIP Memberships