Golfer Registration Form Name ____________________________________ Name ____________________________________ Name ____________________________________ Name ____________________________________ Registration Costs Pre-purchase Raffle Tickets # of Golfers ____ x $125= Golf Total _______ Raffle Total _______ TOTAL ENCLOSED _______
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Check (Check #________) Card #__________________________exp_____ Signature________________________________ Printed Name_____________________________ Address__________________________________ Phone___________________________________ Please make checks payable to: Mail this form to: Or Fax to: (860) 346-1869
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