Qualifier Application

Date: June 2nd, 2014
Course: Gorge Vale Golf Club
Address: 1005 Craigflower Road Victoria BC
Phone Number: 250-383-6451

View the Open Qualifying Procedures & Information Sheet

Entry Deadline: Entries must be received at the Island Open Golf Society by 5:00 pm (local time) on the Wednesday (non members) and Friday (members) preceding the Open Qualifying competition. Entries late or incomplete are not acceptable. Faxed entries with a valid credit card will be accepted. Telephone entries will NOT be accepted.

Fill out the form below, or download the printer-friendly version and fax it to us at:
250-380-5217


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  11. Status
  12. Handicap
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  18. Membership
  19. Payment Options
  20. Cardholder acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth in the Cardholder’s agreement with the Issuer.
  21. TELEVISION, RADIO, MOTION PICTURE, PHOTOGRAPHIC, ELECTRONIC, INTERNET AND SIMILAR RIGHTS/DECLARATIONS:
  22. The undersigned hereby grants and assigns to PGA TOUR, Inc., without limitation, the undersigned’s individual television, radio, motion picture, photographic, electronic, internet “Interactive Applications” (as defined below) and all other media rights with respect to the undersigned’s participation in the qualifying tournament or any portion thereof (i.e., at all times on-site during Tournament week and during any Tournament-related activities), or any other footage of the undersigned that may be captured by PGA TOUR Entertainment or its contractors with the undersigned’s permission, with the understanding that PGA TOUR’s use thereof shall be limited to the following: (1) advertising, promoting or publicizing the PGA TOUR Canada, PGA TOUR, PGA TOUR charitable initiatives, tournaments or any broadcasts thereof; (2) live broadcasts during tournaments, (3) broadcasts or exhibitions on a recorded basis as part of a program or motion picture of tournaments or year-end summaries of sports award programs or any news of sports news programs; provided, that in no case shall the rights granted hereunder be used in any program or motion picture designed for instructional purposes without the express written consent of the player(s) involved; and (4) live or taped non-exclusive updates. “Interactive Applications” shall mean the presentation in any medium in a way that permits the viewer to interact with or manipulate the presentation or access other relevant information during the presentation. The undersigned agrees to refrain from any action which will interfere with PGA TOUR’s ownership of the rights hereunder granted and assigned to PGA TOUR or with any authorized use thereof. The undersigned also agrees to abide by and be governed by the PGA TOUR Tournament Regulations currently in effect (and, if a member of PGA TOUR, attest that a copy thereof has been furnished to me) and by the Rules of Golf of the United States Golf Association, subject to any modifications thereof approved by PGA TOUR. The undersigned hereby declares that they have the financial capacity to support themselves on the PGA TOUR Canada for one full year and that the foregoing information furnished by player in the Application is true and complete; and understands that any material false statements herein furnished by player may result in their expulsion from the Tournament and the suspension or termination of their playing privileges in tournaments cosponsored, approved or endorsed by PGA TOUR.
  23. By submission of this entry, I agree to the following: • I agree to the regulations on Exhibit A included herewith and I agree that my entry is subject to rejection at any time. • I agree that certain risks are inherent to the game of golf and accept personal and sole liability for all such risks. • I agree that the responsibility of insuring this application is received no later than the applicable entry deadline as set forth on Exhibit A is mine alone and that this application will be automatically rejected if it is received after such date and time. • I agree that the risk of delay lies solely with me and that the tournament has no liability with respect to any such delay and the consequences there from, including rejection of this entry. • I agree that the application must be completely executed before I will be entered in the Tournament. Note: Successful open qualifiers MUST use equipment which conforms to the Condition of Competition for Groove Specifications (see below) when playing the PGA TOUR Canada tournament proper.
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