Registration

GOLF OUTING & DINNER REGISTRATION

Gourmet Hawaiian Dinner with your choice of...
1. Grilled filet mignon
2. Teriyaki glazed shrimp & conch fritters with papaya sauce
3. Pan roasted pork with spicy ragout of mushrooms, onions & cherry peppers

Golf Outing & Dinner

Golfer #1:

Phone:

Dinner:

Shirt Size:

Golfer #3:

Phone:

Dinner:

Shirt Size:

Golfer #2:

Phone:

Dinner:

Shirt Size:

Golfer #4:

Phone:

Dinner:

Shirt Size:

Benefit Dinner Only ($75.00 per person)

Attendee #1:

Phone:

Dinner:

Attendee #3:

Phone:

Dinner:

Attendee #2:

Phone:

Dinner:

Attendee #4:

Phone:

Dinner:

Your Name:

Company:

Address:

City: ST: ZIP:

Work Phone:

Home Phone:

Email: