FOUR PERSON SCRAMBLE FORMAT

 

SIGN UP AS A SINGLE, PARTNERS OR FOURSOMES

 

ENTRY FEE  - $100 PER PERSON OR $400 PER TEAM   DINNER AND PRIZES FEE FOR NON GOLFERS - $15 PER PERSON

 

 

RESERVATION INFORMATION

 

 

PLAYER 1 NAME (TEAM CAPTAIN): ______________________________

 

ADDRESS: ____________________________________________________________

 

CITY: ____________________________      STATE: ______    ZIP: ______________

 

HOME PHONE: (_______) ___________   WORK PHONE: (_______) ___________

 

EMAIL: ________________________________________________________________

 

PLAYER 2 NAME: ___________________________________________________

 

PHONE:____________________  EMAIL:___________________________________

 

PLAYER 3 NAME: ___________________________________________________

 

PHONE:____________________  EMAIL:___________________________________

 

PLAYER 4 NAME: ___________________________________________________

 

PHONE:____________________  EMAIL:___________________________________

 

 

Make checks payable to the Broomfield Lions Club and mail registration form to

 

Broomfield Lions Club

12570 Vrain St.

Broomfield, Colorado 80020