2007 Shootout at Warner Springs Ranch
Competitor Registration Entry Form
NAME: _______________________________________________________________
ADDRESS: ____________________________________________________________
CITY: _______________________ STATE: ____________ ZIP CODE: __________
PHONE: _________________ E-MAIL ADDRESS: __________________________
DATE OF BIRTH: ___________/_________/________ (REQUIRED INFORMATION)
ENTRY FORM MUST ACCOMPANY PAYMENT
(Entry fee covers Welcome Reception for competitor and 2 guests plus the Welcome Goody Bag.)
Your paid Entry must be received on or before August 3rd, 2007
FORM OF PAYMENT: CHECK MONEY ORDER
DIVISION: CIRCLE ONE:
$200 Open Division (18 +) limited to 59 entries
$150 Senior Division (45 ? 52) limited to 29 entries
$100 Super Senior Division (53 ? 60) limited to 19 entries
$100 Grand Champions Division (61+) limited to 19 entries
$100 Ladies Division limited to 19 entries
I understand and will abide by the rules of Long Drive Golf Events and also grant Long Drive Golf Events the use of my name, picture, title and/or likeness for its promotional advertising of the Long Drive Golf Events and all its events:
SIGNED & DATED: _______________________________________________________
PLEASE MAIL ENTRY TO:
LONG DRIVE GOLF EVENTS c/o Brenda Prudham
P.O. 203 Warner Springs, CA 92086
760-473-5604 or 760-782-0052
bprudham@hughes.net
