65 Roses Golf Day Registration

Title

First Name

Last Name

Company Name (if applicable)

Address

Suburb

State

Post Code

Phone

Fax

Email

Player 1 Name & Handicap*

Player 2 Name & Handicap*

Player 3 Name & Handicap*

Player 4 Name & Handicap*

I wish to register a team of 4 ($1000)

I wish to register: 1 person ($250) 2 people ($500) 3 people ($750)

I wish to register a hole sponsorship ($1500)