Rotary Club of Southington

Golf Foursome Registration

                                                                                                                                                

Registration includes:  Greens fees, carts, refreshments, lunch and dinner, prizes and awards.  $150/per person.

PLEASE PRINT

Team Captain’s Name                                                                                                                                                   ____

Email                                                      

Phone                                                        

Player #2                                                                                                                                                          

Player #3                                                                                                                                                          

Player #4                                                                                                                                                         

Number attending Lunch                      Number attending Dinner/Awards Reception                          

Additional Dinner Guests @ $50/person  #                         

Payment (payable to: Rotary Club of Southington) no later than July 2, 2011

            Mail to: Image Marketing Consultants

c/o Kate Sirignano

876 South Main Street

            Plantsville, CT 06479