Honoring the Service of Ralph Pinkard and Graham Davis

REGISTRATION FORM

Name of Golfer:__________________________________________________________

Address: _______________________________________________________________

_______________________________________________________________________

Phone: Home: (______)________________________

Office:(_____)________________________________

e-mail address: __________________________________________________________

Names of golfers in foursome: (singles/doubles will be paired!)

Golfer #2:______________________________________________________________

Golfer #3:______________________________________________________________

Golfer #4:______________________________________________________________

DATE: Monday, June 12, 2006
TIME: 12:00 pm Registration • 1:00 pm Shotgun Start (Captain’s Choice)
LOCATION: Twin Lakes Golf Course • 6201 Union Mill Road • Clifton, VA

DIRECTIONS: Take the Fairfax County Parkway to Braddock Road west. Take Braddock Road west about 21⁄2 miles to Union Mill Road. Turn left on Union Mill Road. Take Union Mill Road to a left turn into Twin Lakes Golf Course.

ENTRY FEE: $85 donation per person covers 18 holes of golf, golf cart, practice tee and balls, drinks on course, putting contest, supper, prizes, and a small donation to Pohick Church’s Building Fund. Three (3) mulligans for $5.00 per player available. Buy at registration table! Additional suppers available for guests at $12 per guest. Make checks payable to Pohick Church. Designate Golf Tournament.

REGISTRATION DEADLINE: May 15, 2006 - The golf course needs to plan for the number of teams playing. Late registration should be coordinated with Tom Bland.

MAIL or FAX REGISTRATION: Pohick Church, 9301 Richmond Hwy, Lorton, VA 22079
Fax • 703-339-9884

CHAIR PERSON: Don O’Connell • doconnel@dp-assoc.com
ADVERTISING (Tee Sponsors): Bob Bartlett • rcbsys@aol.com
REGISTRATION: Tom Bland • tbland6677@aol.com
PRIZES: Jim Hayes • jas.hayes@verizon.net

“What better way to spend a Monday afternoon than chasing a little ball with friends!”