Golfer Registration PROCEEDS WILL BENEFIT:
CHAZY YOUTH HOCKEY Presents their annual CHAZY YOUTH HOCKEY MEMORIAL GOLF TOURNAMENT SUNDAY JUNE 4, 2017 8:00 AM Shotgun Start
HOSTED BY NORTH COUNTRY G.C. Inc. 18 hole Championship Golf Course Full Service Restaurant and Lounge ROUSES POINT NEW YORK
For questions, please contact North Country GC
[email protected] 518-297-5814 Or Amy House 298-4925 DaleAnne Wolter 493-2304 Please arrive by 7:30am for check in
The undersigned hereby agree to hold North Country Golf Club & Chazy Youth Hockey free and harmless from any and all claims that may be created by the actions of the undersigned. Player 1 (Captain) Name _____________________________________ Address ___________________________________ ___________________________________ E-Mail ___________________________________ Signature __________________________________
North Country Golf Club 862 HAYFORD ROAD Rouses Point, NY 12979
Player 2 Name _____________________________________ Address ___________________________________ ___________________________________ E-Mail ___________________________________
FORMAT: Scramble COST: $75.00/PLAYER
Signature __________________________________
AWARDS WILL BE GIVEN FOR THE FOLLOWING st
1 Place Team Longest Drive Closest to the Pin Most Honest Team (36th Place)
Player 3 Name _____________________________________ Address ___________________________________ ___________________________________ E-Mail ___________________________________ Signature __________________________________ Player 4 Name _____________________________________ Address ___________________________________ ___________________________________ E-Mail ___________________________________ Signature __________________________________ PLEASE MAKE CHECKS PAYABLE TO “CHAZY YOUTH HOCKEY” MAIL COMPLETED FORM TO: AMY HOUSE 641 STETSON RD CHAZY NY 12921
SPONSORSHIP OPPORTUNITIES Deadline for golfer registration is May 26, 2017 After May 26th call 518-297-5814 to confirm availability Sponsors & golfers please complete information on back _____ $300.00-Foursome Includes lunch _____ $75.00-Single Entry Includes lunch -------- $55.00-North Country Member Includes lunch CHAZY YOUTH HOCKEY
--------$350.00-Foursome & Tee Sponsor Includes lunch
www.chazyyouthhockey.org
------- $125.00-Single Entry & Tee Sponsor Includes lunch
SUNDAY JUNE 4, 2017 8:00 AM
_____$ 90.00-New Tee Sponsor
Please arrive by 7:30 for check in
Please make checks payable to Chazy Youth Hockey Mail completed form to: 641 STETSON RD CHAZY, NY 12921
North Country Golf Club 862 Hayford Road Rouses Point, NY 12979 Chazy Youth Hockey C/O Melanie Guay 8814 Route 9 Chazy, NY 12921
____ I am unable to attend but would Like to contribute a raffle item Or make the following tax Deductible donation: $ ____________
Amy House 641 Stetson Rd Chazy, NY 12921
_____ $75.00-Existing Tee Sponsor