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Player #1

Name : Age:

Address :

City: State: Zip:

Phone: Work Phone: Email:

Player #1 Handicap Verification

My current USGA handicap index is:

This is verified by (Name):

(Title): Phone Number:

Club Issuing Handicap:

Player #2

Name : Age:

Address :

City: State: Zip:

Phone: Work Phone: Email:

Player #2 Handicap Verification

My current USGA handicap index is:

This is verified by (Name):

(Title): Phone Number:

Club Issuing Handicap: