Player One   

E-Mail   

Player Two   

E-Mail   

Player Three   

E-Mail   

Will Play on:

November 4        November 11       Both Sundays

Charge Team (Team Entry of $60.00 or $110.00 per player) to:

Name on Card   

VISA    MASTERCARD    DISCOVER

Card Number   

Expiration         Month    January February March April May June July August September October November December     Year   

Any Extra Requests?