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Jimmy Fund Golf Classic Registration Form

8th ANNUAL FAIRWAY RESTAURANT JIMMY FUND GOLF CLASSIC

Deadline for Registration is September 2, 2009. All fees are non-refundable.

Please register the following golfer(s) for the Fairway Restaurant Jimmy Fund Golf Classic
at $125.00 per person.

My Information

Name
Company
Address
City
State
Postal Code
Work Phone
Email
Check the appropriate selection:

Companion 1

Companion 1
Company
Address
City
State
Postal Code
Work Phone

Companion 2

Companion 2
Company
Address
City
State
Postal Code
Work Phone

Companion 3

Companion 3
Company
Address
City
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Postal Code
Work Phone