Please return with a $55.00 check (payable to "Fair Ladies") by April 1st, 2011 to:

Belinda Cush

Fairways Golf & Country Club

750 Country Club Lane

Warrington, PA 18976

_______ 9 Hole League (Non-Tournament)         _______18 Hole League

NAME _____________________________________________ PHONE ____________________________

ADDRESS ________________________________________________________________________________________

Number Street City ST ZIP

E-MAIL ADDRESS _____________________________________

Birthdate:_____________________

month / day

I usually prefer to: RIDE _______ WALK _______

____I WILL golf on April 8th

____I WILL golf on April 15th