OIJGC Optimist International Junior Golf Championships

  Registration Form

Regional Qualifier and West Mo District Qualifier

Name: _____________________________ Date of Birth ___________Ave/Score: ____

Address: _______________________________Phone: _______________M: ____F:____

City: ____________________________ State: _____ Zip Code: ___________

Emergency Contact: _________________________ Day Phone: ________________

Amateur Status:  “I certify that I am any amateur according to the rules of USGA and this information is true to the best of my knowledge.” 
           Applicant’s Signature: ___________________________

Liability Release:  “I hereby release the sponsors from any liabilities which might occur during my child’s participation in this Optimist-sponsored junior golf tournament.”
            Parent’s Signature: ______________________________

Regional Qualifying tournaments in the West Mo District are held for boys and girls ages 14-15 and 16-18. Younger golfers may compete in regional tournament with permission of the tournament director. Eighteen year old golfers must be currently in high school or a May graduate. (OIJGC offers competition for ages 10 through 18 years; see “at large” below.)

At Large Field -  At large applicants should contact the Sports Programs Dept of Optimist International, 800-500-8130 ext 209, oijgc@optimist.org.

Indicate the tournament for which you are making application, and submit to the appropriate tournament director:

Tournament Location: ___________________________

Date of Tournament:_________________

Registration Fee encl: ($45)________ Age Division: _________

Juniors may play in any of the regional qualifying tournaments, regardless of residence, in an attempt to meet eligibility criteria for district and/or international competition. Qualifying criteria are set at 8% of the field in each age division. A district qualifying tournament is held to determine the winner, with expenses paid, of each age divisions of the entire field. (Only MO residents are eligible for expense-paid trips.) All are welcome to compete to qualify.

Mail to John Thiel, 7214 Wallace Ave, Kansas City, MO 64133, If less than a week until tournament, please call then bring the registration and entry fee to the course.