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場地

: 清水灣鄉村俱樂部

日期

: 2011 年 8 月 26 日 (星期五)

時間

: 12:00 - 20:00

開球時間

: 13:30

最低籌款額

: 每位球員捐款港幣$3,000或 隊際 $12,000 (四人一組)

賽制

: 總桿及淨桿(新新貝利亞)

名額

: 108名 (名額有限,先到先得。)

截止日期

: 2011 年 8 月 19 日

Venue

: The Clearwater Bay Golf & Country Club

Date

: August 26, 2011 (Friday)

Time

: 12:00 to 20:00

Tee-off time

: 13:30

Entry fee

: Minimum $3,000 per player and Minimum $12,000 per team (group of 4)

Format

: Gross & Net (New New Peoria)

Quotas

: 108 players (first come first serve)

Enrollment deadline

Hole-in-One Prize Sponsor :

: August 19, 2011


2011 Habitat Golf for Charity Tournament

仁 人 家 園 慈 善 高 球 日 2011 2011年8月26日星期五 @ 香港清水灣鄉村俱樂部 26 August 2011, Friday @ Clearwater Bay Golf & Country Club

登記表格 Registration Form 截止報名日期: 2011年8月19日 / Registration Deadline: 19 August 2011 個人參賽者 Individual Entry - HK$3,000 :

隊際參賽者 Team of 4 Entry- HK$12,000 :

姓氏 Surname

名字 Given Name

隊名 Team Name :

稱謂 Title

聯絡電話 Contact No.

1

Mr / Mrs / Ms

2

Mr / Mrs / Ms

3

Mr / Mrs / Ms

4

Mr / Mrs / Ms

電郵 Email Address

球衣尺碼 Golf Shirt Size

付款方法 Payment Methods : * 支票 Cheque : □

( Payable to " Habitat for Humanity China Limited " ) (支票抬頭請寫 " Habitat for Humanity China Limited ")

Cheque No: 支票號碼:

* 銀行轉帳 Direct Bank-In / ATM Transfer: □ 「仁人家園」香港上海匯豐銀行戶口號碼:( HSBC a/c# 502-476591-002 ) * 信用咭 Credit card : VISA □

MasterCard □

American Express □

持卡人姓名 Cardholder's Name : __________________________________________________________________________________________ 信用卡號碼 Card No. : __________________________________________________________________________________________________ 有效日期 Expiry Date : ___________M __________Y (最少三個月內有效 Valid for the next three months)

持卡人簽署 Cardholder's Signature : * 請將支票連同此參加表格郵寄至香港中環德輔道中181號大新行17樓。 Please send the cheque together with this entry form to us by mail to the address below: 17/F., Sun House, 181 Des Voeux Road Central, Hong Kong * 使用信用咭或銀行轉帳付款, 請將銀行存款收據連同此參加表格傳真至 2520 4020 或電郵至 charitygolf@habitatchina.org For credit card and direct bank-in payment, please send this entry form with the bank-in slip to us by fax to 2520 4020 or by email to charitygolf@habitatchina.org * 捐款將會獲發正式收據,憑收據於香港作申請稅務寬減。 An official donation receipt will be issued for tax-deduction in HK. 備注 Remarks : *

捐款將不設退款要求。如參賽者或嘉賓不能出席當日活動,可由其他親友代替。 Donation is not refundable. If players or guests cannot attend the tournament, they are advised to have replacement by others.

*

個人資料絕對保密,並只供仁人家園內部用途。 All personal data collected will be treated as strictly confidential and for Habitat's internal use only.

聲明 Declaration : 各參加者須填寫此聲明 All applicants must sign this declaration *

本人健康及體能良好,適宜參加上述活動。本人在參加活動時如有任何傷亡,仁人家園無需負責。 I am healthy, physically fit, and suitable to participate in the above activity. Habitat for Humanity China will not be liable for any injury or death when I am taking part in this activity.

申請人簽署 Applicant's Signature :

日期 Date :

2011 Habitat Golf for Charity Tournament  

2011 Habitat Golf for Charity Tournament

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