dph go 2015 registration
DESCRIPTION
Registration Form for the 3rd Annual DPH Go Golf Outing.TRANSCRIPT
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JOIN US: August 30th Medina Country Club
5588 Wedgewood Road Medina, OH
330.725.6621 REGISTRATION DUE:
JULY 31st
3rd ANNUAL DPH GO GOLF OUTING TITLE SPONSOR: KAL SALES, INC.
to benefit
GOLFER REGISTRATION Golf registration is $100 per golfer. Includes golf fees, golf cart + GPS, collared golf shirt, dinner and drinks. If you are registering as a foursome ($400), please include all names in your group. We will match up single and double registrations into foursomes.
DINNER REGISTRATION Dinner-only tickets are available for $25 OR Dinner + Golf shirt are available for $45 If you would like to join us, please provide the following information for each ticket:
Please make checks payable to DPH Go and send to one of the following addresses: Marilyn Chase Norbert B. Chase 440.537.8335 216.695.4760 [email protected] [email protected] 3505 Boston Road 6855 Boneta Rd. Brecksville, OH 44141 Medina, OH 44256
GOLFER #1: _____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________
GOLFER #2: _____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________
GOLFER #3: _____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________
GOLFER #4: _____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________
ATTENDEE #1:____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________
ATTENDEE #2:____________________________ ADDRESS: ______________________________ ________________________________________ EMAIL: _________________________________ PHONE #: _______________________________ SHIRT SIZE: _____________________________