389 Bryan Pt. Drive, Chula Vista CA 91914

 Phone: (619) 934-2551  Fax: (619) 271-6659

Web Site: www.usabf.com       Email: USABF

June 5, 2009 at Salt Creek Golf Club  - 1 pm Shotgun Start

(1) Complete form, (2) sign, (3) print and (4) fax or mail to USABF

Fax number and mailing address shown above
 
Team Name: 
 
Name: 
Mailing Address: 
             City: St: Zip
Home Phone   Email:
 
 
Golfer 1:
Golfer 2:
Golfer 3:
Golfer 4:
 

Entry Fee $90 Per Golfer
 Number of Golfers          Total $

Mulligans (one per golfer) $5

  Number of Golfers          Total $

Grand Total $

 
Payment Method:   Check#
                               Credit Card:     Visa       MasterCard        American Express

                               Credit Card Number:    

                                      Expiration Date:     **Security Code
**Your card security code for your MasterCard or Visa card is a three-digit number on the back of your credit card, immediately following your main card number. The card security code for your American Express card is a four-digit number located on the front of your credit card, to the right or left above your main credit card number.
 
                               Name on Credit Card:    
                               Billing Address:    
                                                            
                                                            
         

Signature
 
 
                                       Phone: