Friday, June 16, 2017 9:00am Shotgun Start

Carlowden Country Club

4-Person Captain and Crew
$80 per person/$320 per team
Mens, Womens & Co-Ed Divisions
Sponsored by
A Hole-In-One Contest for a New AmeriCU
Car
Sponsored by Lowville New Car Dealers Association
Cash Prizes Closest to the Pin Skins Game Raffles
Entry fee includes: Greens fees, one cart per foursome, shirt, continental breakfast,
lunch on the course and a barbecue after the tournament
Note: The skins game is optional and an additional fee
Registration: 8:00am
Tournament/Raffle prize winners announced: 3:00pm

Captain: _______________________________ HNDCP: _____________Gender/Shirt Size____________

Captain Phone: ________________________ Email: ___________________________________________

Crew: _________________________________ HNDCP: _____________Gender/Shirt Size____________

Crew: _________________________________ HNDCP: _____________Gender/Shirt Size____________

Crew: _________________________________ HNDCP: _____________Gender/Shirt Size____________

Please send completed registration form and fee by June 2nd to: Lewis County Hospital Foundation,
7785 North State Street, Lowville, New York 13367