ldst

TEAM REGISTRATION FORM FOR PRO-AM 2012

GOLF PRO

FIRST NAME: LAST NAME:
ADRESS : CITY:
ZIP CODE: COUNTRY:
GOLF CLUB: GOLF CITY:
MOBILE NUMBER: E-MAIL:
POLO SHIRT SIZE:            S      M      L      XL      XXL
ACCOMMODATION REQUEST / ROOM TYPE     
WED 17/10    THU 18/10    FRI 19/10    SAT 20/10    SUN 21/10


AMATEUR 1

FIRST NAME*: LAST NAME*:
COMPANY: FUNCTION:
ADRESS : CITY*:
ZIP CODE: COUNTRY:
GOLF CLUB: GOLF CITY:
INDEX: LICENCE NO:
MOBILE NUMBER*: E-MAIL*:
POLO SHIRT SIZE:            S      M      L      XL      XXL
ACCOMMODATION REQUEST / ROOM TYPE     
WED 17/10    THU 18/10    FRI 19/10    SAT 20/10    SUN 21/10


AMATEUR 2

FIRST NAME*: LAST NAME*:
COMPANY: FUNCTION:
ADRESS : CITY*:
ZIP CODE: COUNTRY:
GOLF CLUB: GOLF CITY:
INDEX: LICENCE NO:
MOBILE NUMBER*: E-MAIL*:
POLO SHIRT SIZE:            S      M      L      XL      XXL
ACCOMMODATION REQUEST / ROOM TYPE     
WED 17/10    THU 18/10    FRI 19/10    SAT 20/10    SUN 21/10


AMATEUR 3

FIRST NAME*: LAST NAME*:
COMPANY: FUNCTION:
ADRESS : CITY*:
ZIP CODE: COUNTRY:
GOLF CLUB: GOLF CITY:
INDEX: LICENCE NO:
MOBILE NUMBER*: E-MAIL*:
POLO SHIRT SIZE:            S      M      L      XL      XXL
ACCOMMODATION REQUEST / ROOM TYPE     
WED 17/10    THU 18/10    FRI 19/10    SAT 20/10    SUN 21/10


CONTACT PERSON FOR THE TEAM

NAME: EMAIL*:
MOBILE NUMBER :  


SPECIAL REQUESTS





COST SUMMARY

PRO-AM OF SAINT-TROPEZ without accomodation

PRO...............................................................................................................................FREE
PRO-AM TEAM..................................................................................... 1400 € x 3 = 4200 €
TEAM GASSIN..................................................................................... 1000 € x 3 = 3000 €
NON GOLFER PARTNER...........................................................................................600 € x
TOTAL          


REGISTRATION WILL BE CONFIRMED ONLY AFTER RECEIVING FULL PAYMENT
IN CASE OF CANCELLATION FULL REIMBURSEMENT EXCEPT 200 € BEFORE AUGUST 15, 2012
NO REIMBURSEMENT AFTER AUGUST 15, 2012

HOTEL PARTNERS NEGOCIATED RATES
ROOM BOOKING TO BE DONE BY PSO PRODUCTION AND TO BE PAID DIRECTLY BY GUEST TO THE HOTEL THE DAY OF DEPARTURE

METHOD OF PAYMENT

PAYMENT BY PAYPAL

BANK WIRE TRANSFER
  TO PSO PRODUCTION LTD / EURO ACCOUNT
  ING BELGIUM (BRUSSELS)
  IBAN : BE86 3101 7739 9750
  SWIFT CODE: BBRU-BE-BB