PARTICIPATION ENTRY FORM

Name*


Address* (please include your city, state, and zip code)


Phone*


Email address*



I would like to register the following participants:

Individual Golfer(s) - $350 ea.
Foursome (4 golfers) - $1300

Dinner & Silent Auction Only - $75 ea.



Golf Participant Information
Golfer 1 Name:


Handicap Index (0-36):

Shirt Size:


Dinner Guest:

Golfer 2 Name:


Handicap Index (0-36):

Shirt Size:

Dinner Guest:

Golfer 3 Name:


Handicap Index (0-36):

Shirt Size:

Dinner Guest:

Golfer 4 Name:


Handicap Index (0-36):

Shirt Size:

Dinner Guest: