Casa de Campo Seniors 2009 Registration

Player Information

*Name       Mr.      Ms.                                                                  GHIN #: Index:                                    Age:

Spouse       Mr.      Ms.                                                                   GHIN #: Index:                                   Age:

Personal Information

*E-mail:                                                                                      *Phone:

Address:

City:                                                                       State:                                         Zip:

Country:                                                                 Phone 2:                                     Fax:

Flight Information

Arrival Date:                                                 Airport                                                      Flight #:

Departure Date:                                           Airport                                                      Flight #:

I would like my room close to:   1.

                                            2.

                                            3.

Packages Information (Please choose. Packages include Hotel Room:)

      Golfer Double Occupancy ($ 2,212.00 USD per person)
      Golfer Single ($ 2,675.00 USD)
      Non-Golfer Double Occupancy ($ 1,497.00 USD per person)
      Extra night(s) - Double occupancy $198.00 X Number of nights:

                                  Single occupancy $264.00 X Number of nights:


Registration Agreement:
Upon receiving my application the Golf Office of Casa de Campo will contact me for my credit card information. I hereby authorize Casa de Campo to charge a deposit of $200.00 US per person to my credit card starting September 10^th and the cost of the entire package starting October 15^th, 2009. If I fail to cancel on or before October 15^th or do not show, a $200.00 US cancellation penalty per person will be deducted from the cost of the total package and the balance will be refunded.

    * I agree with the registration agreement terms above. (This MUST be checked to proceed with registration.)

For additional questions, comments or requests.

Please reserve your direct flight from Miami to Casa de Campo International Airport! See you in November.

Fax or email entry form to:
Gilles E. Gagnon
809-523-8800 or email / golf@ccampo.com.do

Tournment Package(s):	Hotel Rooms
Golfer double occupancy:	$ 2,212 US p/p
Golfer single occupancy:	$ 2,675 US
Non golfer double occupancy:	$ 1,497 US p/p
Extra night - Double occupancy	$ 198 US p/p
Extra night - Single occupancy	$264 US