Please Clearly Print Names
Player Name: ____________________________________
In Honor Name(s)		In Memory Name(s)
Total Donation Enclosed                              $
Deadline: This form and Checks in Jan's hands on or before Thursday, September 1st
Checks Payable to: CGC 18-Hole Women's Association
Mail: This Form, Entry Fee Check & Donation Check: Jan Baxter, 3 Vicksburg Ave., Harwich, MA 02645