08/19/2012
Golf Registration Form
(Please submit all participant information by August 24, 2012)
Please make all checks payable to:
DON “BLUE 10” MILLIGAN MEMORIAL FUND
Enclosed is my payment of $________
I/We can not attend, but would like to make a donation of $___________
Sign up for: Price
Individual Player Registration $85.00
Buffet Luncheon Only $25.00
NAME: ________________________________________
ADDRESS: _____________________________________
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Phone: _______________________________________
E-Mail: _______________________________________
Others in Team Registration
NAME: ________________________________________
ADDRESS: _____________________________________
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Phone: _______________________________________
E-Mail: _______________________________________
NAME: ________________________________________
ADDRESS: _____________________________________
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Phone: _______________________________________
E-Mail: _______________________________________
NAME: ________________________________________
ADDRESS: _____________________________________
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Phone: _______________________________________
E-Mail: _______________________________________
