I wish to enter the 2010 Father's Day Championship.

Your name     Age  Sex:M/F
No. & Street  Apt No.    
City & State  Zip
Your club     Hdcp index
Phone No.     Email

Partner name  Age  Sex:M/F 
No. & Street  Apt No.    
City & State  Zip
Home club     Hdcp index
Phone No.     Email
Relationship of partners

Note: Age and sex information are needed to determine tee assignments.   

Enclosed is a $225 check or money order payable to JAGA

Optional contribution to JAGA Scholarship Fund $

Entries close June 21, 2010

Verify your entries above then print this form.  Send it and your check to:

Larry Dismore, Tournament Chairman
12741 Shinnecock Ct.
Jacksonville, FL 32225

Entries must be received 7 days 
prior to the tournament.