Registration will open April 1, 2011 for players on the 2011 exempt list.  For all others, registration will begin April 15.

2011 Western Printing Pro-Am at Moccasin Creek

July 22-24

PROFESSIONAL ENTRY FORM

Field Limited to 50 Pros - First 40 Exempt Pros entered by June 22 will be guaranteed a spot – Exempt Pros entering after June 22 or after 40 Exempt Pros have been accepted MUST QUALIFY during the July 20 Qualifying round – Non-exempt Pros must qualify

Name:                                                                                                                            

Address:                                                                                                                        

City:                                                    State:                   Zip:                                       

Phone:                                                     Mobile Phone:                                                  

E-Mail Address:                                                                                                             

Social Security #:                                                                 (Required before your entry will be accepted)           

Exempt Pro Entry Fee: $750 (practice round, lunch on tourney days, & range balls included)                      

Qualifier Entry Fee: $800 ($750 refunded for non-qualifiers - lunch included)                                             

Rental Cart Prepay $17 per day (Circle Days: Wed - Thu – Fri – Sat - Sun)                      

Extra Friday Dinner Tickets $20 (Pros dinner included in entry)                                                     

TOTAL ENCLOSED (Payment must accompany entry to be confirmed into event)                           

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ENTRY for PRO-SPONSOR Event on July 20 - EXEMPT PROS ONLY – SPACE LIMITED! 

           I am an Exempt Pro and wish to play – no entry fee                  
           I am a Non-Exempt Pro and wish to be on the waiting list – no entry fee

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Payment Type:  ___ Cash        Check        Money Order         Credit Card

Credit Card Info: 

Name on Card:                                                                         

                   Type of Card:                                                (Visa/MasterCard/AmEx/Etc.)

                   Card Account #:                                                                      

                   Expiration Date:                                 V-Code on back of card:           

Send, Fax, or E-mail Entry Form with Payment To:

Western Printing Pro-Am at Moccasin Creek

            39084 130^th Street

            Aberdeen, SD  57401

            Phone:  605.226.0989     Fax:  605.226.1523     Email:  dean@moccasincreekcc.com    

Website:  www.moccasincreekcc.com                  Dakotas Tour Website:  www.dakotastour.com

NOTE:  Dakotas Tour Professional Refund Policy 

·         Cancellations after July 15 will be charged a $50 Administration Fee.

·         All refunds for players canceling are made the week after the event is concluded.

·         In case of a total rainout, all players will receive an 80% refund.