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Golf Lesson Registration Form

Please fill out information below and enter to win a 3-hour lesson package

First name__________________________________________

Last name__________________________________________

Email______________________________________________

Phone_____________________________________________

IF PAYING BY CREDIT CARD

Billing Address______________________________________

City_______________________________________________

State______________________________________________

Zip________________________________________________

Credit Card Type (circle one)

Amex Visa MasterCard Discover

Card Number_________________________________________

Card Expiration Date___________________________________

Card Security Code____________________________________