| Applicant Name: |
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| Contact Name: |
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| State: |
|
| Start Date of Event |
 |
| End
Date of Event: (If one day event, end date should be the same as start
date. Quote will contemplate coverage for events continuing past 12:00
AM) |
|
| Address Street 1: |
|
| Address Street 2: |
|
| City: |
|
| Zip Code: |
(5 digits) |
| Daytime Phone: |
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| Evening Phone: |
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| Prize Hole # :?: |
|
| Email: |
|
Yards to Hole (Men' Tee Yardage):
Minimum hole yardage is 125 yards for women and 150 yards for men |
|
| Prize Amount: |
|
| Number of Participants: |
|
| Do you have additional holes you would like to insure for this event |
YesNo |
| Would you like to purchase a Designated Person or Organization as an Additional Insured??: |
yesno |
|
|
