Registration/Entry Form

Russell "Swede" Johnson Memorial Clothe-A-Child Golf Tournament
El Rio Country Club
September 16, 2005
8:0 a.m. shotgun start

 

Name_____________________________________________           Index/Handicap (if known)__________________

 
Telephone ________________________________

 
E-Mail Address _________________________________________________ (optional)

 

Mail your check or money order made payable to Mohave Shrine Clothe-A-Child in the amount of $125 per person with this registration form to the address below.  All entries must be received prior to September 1, 2005. 

 

When completed, print this form and mail to:
Mohave Shrine Club
2580 Miracle Mile
Bullhead City, AZ  86442

Don't forget to include your check for $125. per person

 

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