Entry Form

Saturday, August 22, 2015
(rain date to be determined)

COOSAW CREEK COUNTRY CLUB
4110 Club Course Dr.
North Charleston SC 29420
843-767-9000

SHOT GUN STARTS AT 2:00 PM

Name:_____________________________________________

(Player 1) Phone:____________________

Email:_____________________________________________

Player 2:___________________________________________

Phone:____________________

Email:_____________________________________________

Player 3:___________________________________________

Phone:____________________

Email:_____________________________________________

Player 4:___________________________________________

Phone:____________________

Email:_____________________________________________

Total fees$ 110.00 per Player
Fees include: Cart, Greens Fee, Dinner, $2000.00 prize package
*And a $10,000.00 cash prize for a chosen hole-in-one*
Also 50/50 $ Raffel
ALL PROCEEDS BENEFIT LTRF A 501-C3 NON-PROFIT ORG
To promote Pdestrian/cyclist Safety
Pay online SECURE with PayPal