NAME _______________________________________Social Security #/TAX ID#**______________________PHONE ( )___________________
HOME ADDRESS /NO. & STREET___________________________________CITY ___________________STATE______ZIP CODE_________
Email Address:___________________________________
**Remember: You must have one of these numbers for IRS purposes: Social Security # or Tax ID # or 30% will be taken out of your check if
you do not have one.
Please Check One: PROFESSIONAL __________***AMATUER_________HANDICAP INDEX___________
***NOTE: I understand and agree that by starting as an amateur, I shall remain as such throughout the duration of any event and will be entitled to
receive Merchandise or an Award Certificate as a prize. The amount of the Award is not to exceed the current official prize limitations set forth by
the United States Golf Association. Merchandise and/or Certificates will be determined by the Cactus Tour and committee.
I certify that I will abide by all policies and procedures set forth by The Cactus Tour, and that I will not hold The Cactus Tour liable for any personal injury while competing during the 2012season. I also agree to allow The Cactus Tour to use my name, picture, and any information supplied by me for media purposes.
Player Signature _______________________________________________________________________________ Date_____________________
Check or Money Order payable to: The Cactus Tour / $399____
Paypal / $412____
Remit to: The Cactus Tour/ Mike Brown Questions or concerns email: cactustourgolf@hotmail.com
2395 n 2nd Ave. Contact Numbers 520-312-8642 cell
Tucson , Az. 85705 888-264-5350 fax
*Fee represents a cash discount
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