2008 Golf Tournament

Presented By:

LOCATION: Derby Golf and Country Club
DATE: Thursday, July 10, 2008- 1:00 pm tee time

Please mail payment to:
Derby Chamber of Commerce, PO Box 544, Derby, KS 67037
or call 788-3421 to sign up and pay by credit card.
Fax to 316-788-6861
YOU MUST PAY BEFORE THE DAY OF THE EVENT
Registration fee is $100 per player or $400 per team

Today's Date:________

Team of Four ____ Individual ____


Player No. 1 (Team Captain) ____________________________________________________

Address:____________________________________________________________________

City, State, Zip________________________________________________________________

Phone: ____________________________E-Mail_________________________________


Player No. 2 __________________________________________________________________

Address:_____________________________________________________________________

City, State, Zip________________________________________________________________

Phone: ___________________________E-Mail_________________________________



Player No. 3 __________________________________________________________________

Address:____________________________________________________________________

City, State, Zip________________________________________________________________

Phone: ____________________________E-Mail_________________________________



Player No. 4 __________________________________________________________________

Address:____________________________________________________________________

City, State, Zip________________________________________________________________

Phone: _____________________________E-Mail_________________________________


Registration Deadline: Tuesday July 2, 2008

___Visa ___Mastercard ___Check

Credit Card No.:_________________________________________________________________

Expiration Date: ________________________________________________________________

Signature: ______________________________________________________________________