Entry Form Adult-Junior Joe Durant Saturday, May 18, 2019 @ Tiger Point Golf Club ENTRY DEADLINE: Monday, May 13, 5 PM  PGA Champions Tour Player Limited to the First 50 Registered Teams Format

 Finished first in the 2018 Media and Injury release, required for registration, is located on the back of this form. Two-Player Scramble  PGA Tour Wins: 4 Register Online: www.TheFirstTeeNWFlorida.org Tee Assignments or Adult men will play white tees  PGA Tour Champions Wins: 3 Mail This Form and Payment to: Adult ladies will play red tees The First Tee Northwest Florida Juniors will play age-appropriate tees PGA Tour Single Tournament Record 3924 W. Navy Blvd.  Pensacola, FL 32507 Low Team Awards Holder (90 Holes): 36 under Par

1st through 3rd place based on 2001 Bob Hope Chrysler Classic Make Checks Payable To: 324 (65-61-67-66-65) The First Tee of Northwest Florida Junior Golfer’s age division To Pay by Credit Card: (6–9; 10–13; 14–18) Call 850-456-7010 both male and female  2001 PGA Tour Come-Back Player of The Year Fee: $95 team entry fee includes Adult and Closest to the Pin Awards Junior greens fees, cart, tee gift and for Adults and Juniors on holes 4 & 10; dinner after play/awards ceremony  Top 100 Career PGA Tour Money List Registrations received after 5/13/19 will be: $115 and for Junior Golfers only on holes 2 & 17 Junior-only Fee: $50 ($60 after 5/13/19)  Founder and host of the Joe Durant Juniors who do not have an adult 100 Holes of Golf Marathon ______partner are still encouraged to register; Adult Name juniors will be paired with  Escambia High School Class of 1983 coaches or golfing adults. ______Junior Name  Birthplace: Junior-Only Registration is $50 Pensacola ______Mailing Address

______For More Information City State Zip

______Call: (850) 456-7010 Phone Email: [email protected] Visit: www.TheFirstTeeNWFlorida.org ______Email

_____/_____/_____ Male Female Junior Birthdate

Guest Dinner(s) $15 Quantity ___

Amount Enclosed: $______

2019 I hereby authorize The First Tee of North- west Florida (GPJGA), its agents and assigns and all other media outlets to use Joe Durant and reproduce my name, photograph(s), and/or videotape recordings of me or audio recordings of my voice for any and all Adult-Junior purposes including promotion and advertising. Tournament for all purposes. The First Tee of Northwest Florida shall have the right to telecast the Saturday, May 18 Tournament, or the recording thereof, one or more times on a sustaining or commercial basis, over any cable or network television system as well as any affiliate system or stations.

I agree to hold you and any third parties harmless against any liability, loss or dam- age (including reasonable attorney's fees) caused by or arising from the telecast of my appearance, or any utterance made by me or material furnished by me in connec- tion with my participation therein.

1255 Country Club Rd, I attest and verify that I am physically able Gulf Breeze, FL to participate in this event and am responsi- ble for any injuries that may occur during the Joe Durant Adult Junior. The First Tee of Northwest Florida and its' affiliates, sponsors, Tournament Registration directors, etc. will not be held responsible and Range Open for any medical costs accumulated as a result of injury during this event.

12:30–1:45 pm

Parent/Guardian Signature: Shotgun Start: 2:00 PM ______

Date: ______

3924 W. NavyW. Blvd. 3924 Pensacola,FL 32507 TheTee First of Northwest Florida