Name:_________________________________

Year or affiliation:________________________

Address:_______________________________

City:___________________________________

State:_____________ Zip:______________

Phone:_________________________________

E-Mail:_________________________________

 

Greens Fees:

_____Alumni and Friends of SMFD: $100.00 per person
_____Students and Alumni years '01-'06: $65.00 per person
_____Post Tournament BBQ only: $25.00 per person

 

Amount Enclosed:_____________

 

If you have a preference for a foursome, please list all four members below:

1:_________________________________

2:_________________________________

3:_________________________________

4:_________________________________

 

Please make checks payable to St. Michael's Fire and Rescue

Mail registration forms to:

Mark Wilkin '85
170 East Street
Hingham, MA 02043

mark.wilkin@hinghammutual.com

Registration forms MUST be recieved by August 31, 2006!