1st Annual

Polycystic Kidney Disease Golf Outing

Sunday, September 25th, 2016

9 Holes !!!
Pasfield Golf Course
1700 W. Lawrence
Springfield, IL 62704
Date & Time: Sunday, September 25, 2016 (register by 9/21/16)
Shotgun Starts: at 10:00 am & 1:00 pm (if necessary)
Cost: $40 per player includes 9-hole green and cart fees, lunch, and 1-6 pack of
beverages per cart. Lunch will be served around 12:00 pm.
Format: 2 person scramble
Each shotgun is limited to the first 12 teams to register SIGN UP ASAP!!
_____________________________________________________________________
PKD Golf Outing Registration Form
Player #1______________________Address_________________________________
Phone (____)______________Email_______________________________________
Player #2_____________________Address__________________________________
Phone (____)______________Email_______________________________________
Pairing Requests:_______________________________________________________
Players 1 & 2 will be riding together. Please choose from the following beverage options for players 1
& 2 (i.e. Bud Light 3_ Miller Lite _3_)
Bud____ Bud Light____ Bud Light Lime____ Bud Select____ Miller Lite_____ MGD_____ Busch___
Coors Light____ Mich Ultra____ Other (i.e.Gatorade, bottled soda, tea, water, etc.)______________
________________________________________________________________________________

To be completed by Pasfield GC Staff:

Date:_______________ amount paid $_________________initials:_____
Make checks payable to Pasfield Golf Course