5th Annual Yuma Ammonia Safety Day

Golf Tournament Registration Form

 
     
NOT A FUND RAISER!
                          IT’S A FUN RAISER!		  

 
Wednesday, February 18, 2009
Mesa Del Sol Golf Course
Time to be determined
 Shotgun Start
Buffet starting at a time to be determined -Get there early to eat!

A get-together for attendees, participants and members of our
communities.   No handicaps - just meet, greet and have fun.

INDIVIDUAL ENTRY FEE:  $60.00 (approx) (includes 18 holes of golf, cart and a hamburger buffet prior to the tournament)*
*$40.00 per team skins optional

May enter as a four-person team or as individuals.  Individuals will be randomly
 assigned to teams on the day of the tournament.

REGISTER  EARLY
v Registration and entry fee must be received by February 1, 2009  v

 

CONFIRMATION AND LOCATION MAP WILL BE MAILED UPON RECEIPT OF CHECK

Please make checks payable to Yuma Ammonia Safety Day Committee
Mail to:  P.O. Box 143, Yuma, AZ  85366
Any questions?  Call Barbara Kirpatrick at (928) 344-2488

 

First Name:
Last Name:
Email Address:
Company Name:
Mailing Address 1
Company City:
Company State:
Company Zip

Company Phone:
Company Fax
   
Second Person First Name:
Second Person Last Name

Second Person
E-Mail
   
Third Person First Name:
Third Person Last Name
Third Person
E-Mail
   
Fourth Person First Name:
Fourth Person Last Name
Fourth Person
E-Mail