OZPRIZE HOLE IN ONE PRIZE INSURANCE -QUOTATION REQUEST FORM

CLIENT CONTACT NAME:

INSURED NAME:
ADDRESS:
PC:
TELEPHONE
EMAIL:
EVENT NAME:
DATE(S) OF EVENT:
EVENT VENUE:
VENUE ADDRESS
HOLE NUMBER:
DISTANCE FROM TEE TO FLAG STICK:

MEN: LADIES:


NUMBER OF AMATEUR MENS ATTEMPTS:
NUMBER OF AMATEUR LADIES ATTEMPTS:
NUMBER OF PROFESSIONAL ATTEMPTS:

PRIZE VALUE & DESCRIPTION:

COMMENTS OR SPECIAL REQUESTS:

Thank you for your enquiry, I will revert to you shortly with our QUOTATION and terms. JK