Registration Form

Lewis Ross Golf Tournament

Wednesday, August 15, 2001 - 1 PM Shot Gun Start
Great Chebeague Island Golf Club
18 Hole Scramble - Best Ball

Proceeds to Benefit
Island Commons - an Adult Family Care Home

 Player #1 or Hole Sponsor Information

Name: ______________________________

Mailing Address: _____________________

___________________________________

Daytime Phone #:_____________________

Handicap:_________ Club:_____________

 Player #2

Name: ______________________________

Mailing Address: _____________________

___________________________________

Daytime Phone #:_____________________

Handicap:_________ Club:_____________

 Player #3

Name: ______________________________

Mailing Address: _____________________

___________________________________

Daytime Phone #:_____________________

Handicap:_________ Club:_____________

 Player #4

Name: ______________________________

Mailing Address: _____________________

___________________________________

Daytime Phone #:_____________________

Handicap:_________ Club:_____________


Number of Golf Participants___________

Costs (includes pig roast dinner following tournament):
Single (up to three players): $75 each
Group of Four: $250
Pig Roast only: $25 each: please indicate how many _________

 ______ Hole Sponsorship (company name recognition on hole):

 Silver: $300

Gold: $500


_______Tent Sponsorship (company name recognition at pig roast): $100

There will be a raffle and silent auction the same day
and donations for both will be gladly accepted!

Please complete all information for each golfer and return with your check made payable to:
Chebeague Care Resource, Box 226, Chebeague Island ME 04017
Pre registrations are greatly appreciated!
For more information contact John at 878-5553 extension 106 

Thank you for your consideration and support.