Please Complete Entry Form and Return With

G & B ENERGY

“IRONS IN THE FIRE” GOLFAND SOCIAL

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PLEASE COMPLETE ENTRY FORM AND RETURN WITH

ENTRY FEE AND DONATION AS SOON AS POSSIBLE

ENTRY DEADLINE IS AUGUST 5, 2016

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Name: ______

Company: ______

Address: ______

CityState Zip: ______

Daytime Phone: ______Home Phone: ______

Handicap: ______

Shirt Size: S ____ M ____ L ____ XL ____ XXL ____

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Please complete all information for the other 3 players on your team:

Name: ______Handicap: ______

Address: ______Phone: ______

CityState Zip: ______

Shirt Size: S ____ M ____ L ____ XL ____ XXL ____

Name: ______Handicap: ______

Address: ______Phone: ______

CityState Zip: ______

Shirt Size: S ____ M ____ L ____ XL ____ XXL ____

Name: ______Handicap: ______

Address: ______Phone: ______

CityState Zip: ______

Shirt Size: S ____ M ____ L ____ XL ____ XXL ____

Number of Players (Cedarbrook Members)* ______x $130 = $ ______

Number of Players (Non Members)* ______x $150 = $ ______

Sponsorship level*

___Co-Sponsor($1,500) ___Prime($500) ___Choice($250) ___Select($100) $ ______

Donation to the YadkinValley United Fund– please give generously $ ______

Total Amount Enclosed $ ______

*Entry Fee includes (1 Mulligan, and Skins game and a chance to win $1,000 cash)

Please enclose check payable to: G & B Energy - Golf Tourney

Post Office Box 811

Elkin, NC 28621

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Starting Time:Afternoon Tee Time Only - Shotgun starting at 11:30AM