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Registration Form
Trevor Roberts Benefit Golf Tournament

Team Name:  

Team Contact:  

Address:    

Phone #

Email:    

Players:  

1.

2.

3.

4.

Sponsor Commitment: (must select one of the following three choices)

Hole Sponsor + Team $400 

Hole Sponsor $200 

Team $240

Amount Due: $

Make checks payable to: Trevor Roberts Fund

Mail entry fee by November 1, 2010 to: 

Jason Schroeder, 217 Summit St., McLouth, KS 66054