The 2008 LSBA Golf Fundraiser

Team Registration Form

All proceeds to support Local Military Families

June 13th, 2008    1:00 Shotgun

Nemadji Golf Course
Superior, WI      

FAX TO: GOLF REGISTRATION 715-394-0353  (if paying in FULL)

SEND TO: Mark Carlson/ Nemadji Golf Course  5 North 58th Street  Superior WI 54880 (if paying in FULL)

___________________________________________________________________________________________

TEAM REGISTRATION: Team Name_____________________

                                        $200.00   (Golf/2 Carts/ Goodie Bags/ Prizes/ Dinner)

                            Player 1:__________________ Player 2____________________

                            Player 3:__________________ Player 4____________________

     IF SENDIND Form of Payment: Include full amount due only.  CC / Ck #______

     Name on Card:_________________________

     CARD #______-______-______-______   Expire ___/___   Code_____

Registration for TEAMS may be called directly to Nemadji Golf Course: 715-394-0266 _______________________________________________________________________________

EXTRA DINNER TICKETS:     Adults & Over 13 yrs = $10/meal

                                                            #____ Extra Meal Tickets= $_________

    Form of Payment: Cash/ Check/ CC

    Name on Card:_________________________

    CARD #_____-_____-_____-_____   Expire ___/___   Code____

Questions:  Contact Mike Locker 218-393-1356  or Michelle Simon 218-940-8333