ENTRY FORM

At

Indian Hills

$60.00 per person

Includes: Continental Breakfast

And lunch

Team “Skins” game!

Call: Don Perkins at 332-0172

For details

Registration and breakfast from 7 AM - 7:45

PLEASE PRINT

Captain:_______________________________________ Contact#:______________

Email:________________________________________ Cell#:___________________

Team Member 2:__________________________________

Team Member 3:__________________________________

Team Member 4:__________________________________

*Full Payment must accompany your Entry Form

Name of Sponsor:________________________________

Make Check Payable To: Michael’s Message, Inc.

Mail Check To:

Michael’s Message, Inc.

7506 Roberts Road