2012 Tournament Application Form

* required information
First Name: *     
Surname: *     
Name as it appears on your credit card: * 
Date of Birth (DD/MM/YY): *  / /    
Guest Name:
(optional - £55 extra charge)  
   
Home Address: * Address in Cuba:
(if applicable)
Country of Residence: *    
Postcode / Zip Code: *    
Telephone Contact Number: *
(including country code)

Contact Number in Cuba:
(if applicable)

E-mail Address: *
Handicap (min 28): *    
Home Club: (if applicable)    
Do you require Club rental? Free if required.
Would you like to be informed about other golf events in Cuba?
If so, which address?
Total to Pay (GBP) £ 110