*** Please do not register until after tournament announcement *** Raffle Drawings   Silent Auction   Live Auction

Golf Registration Form Company Name: Contact: Phone: Fax: Email: Retype Email: Address: City: State: Zip: Individual Player's Names 1.        Steak    Fish    Chicken    Pasta 2.        Steak    Fish    Chicken    Pasta 3.        Steak    Fish    Chicken    Pasta 4.        Steak    Fish    Chicken    Pasta I will not be able to attend but would like to make a donation: $ Other Sponsorship Opportunities Tournament Sponsor........... $10,000.00 Dinner Sponsor....................... $5,000.00 Pat Dempsey Sponsor............ $1,000.00 Beverage Cart Sponsor............ $500.00 Goodie Bag Sponsor................. $500.00 Putting Contest Sponsor.......... $500.00 Longest Drive Sponsor............. $500.00 Closest to the Pin Sponsor....... $500.00 Raffle Prize Sponsor................. $100.00 $100 Hole Sponser $100 Dinner Only

Prizes First, Second and Third Place, Longest Drive, and Closest to Pin Entry Fees* $250 per person / $1000 per foursome DINNER ONLY (for non players) - $100 *Includes Green Fees, Cart, Box Lunch, Dinner, Refreshments and Tee Prizes. Dinner choices of Steak, Salmon, Chicken or Pasta. Wine is includes with dinner. Brookside Country Club 1133 Rosemont Avenue Pasadena, CA 91103 (626) 585-3598    www.brookside.americangolf.com *Thomas Guide pg.535/565 PAY BY CREDIT CARD Credit Card# Expiration (## / ##): Amount to Charge: $ Signature (Fax Only):_______________ PAY BY CHECK TO: Project Child Save 2629 Foothill Blvd. Ste. 230 La Crescenta, CA 91214

www.projectchildsave.org
Please do not make payment until after tournament announcement
To Register by Fax Print this FORM and Fax to 866-378-6806