<p> 2016 Srixon International Sub-Junior Hosted by JNJG and Cessnock Golf Club Monday 3 rd October -> Friday 7 th October, 2016 </p><p>Official Tournament Entry Form - $100 AUD (Including GST) (Entry Fee Includes Unlimited use of the Driving Range at Cypress Lakes Golf and Country Club)</p><p>Name - ……………………………………………………………… Sex – M or F DOB - ………/………/……… (dd) (mm) (yyyy) Address - …………………………………………………………………………………………………………………………………….</p><p>Country - …………………………………………………… State - ………………………… Post Code - ………….</p><p>Juniors Mobile Phone Number - …………………………………………………………………………………………………</p><p>Juniors Email Address - ………………………………………………………………………………………………………………</p><p>Parents Name - ……………………………………………. Mobile Phone Number - …………………………..</p><p>Parents Email Address - ……………………………………………………………………………………………………………..</p><p>Home Club - …………………………………………………………………… Golf Link - …………………………………..</p><p>Signature of Player - …………………………………… Signature of Parent - ……………………………………</p><p>Payment Method (please circle) – Cheque / Money Order Credit Card Direct Deposit</p><p>(When paying via Direct Deposit please write 16 Srixon followed by your Surname in the description) (When paying by cheque or money order, please make cheque / money order out to “Jack Newton Junior Golf”)</p><p>Direct Deposit Details – BSB: 082 080 ACCOUNT NUMBER: 028 259 241</p><p>Credit Card Details (please circle) – Visa MasterCard</p><p>Card Number - ………………… / ………………… / ………………… / ………………… Expiry - ……… / ………</p><p>Cardholders Name - ……………………………… Signature - ……………………………… CCV - …………</p><p>Please complete this form and return to JNJG Post – PO BOX A138 ARNCLIFFE NSW 2205 Fax – (02) 9567 7720 Email – [email protected] OFFICE DATE PAYMENT PAYMENT MYOB RECIPT REGISTERED ENTERED TYPE RECEIVED USE ONLY</p>