FAIRWAYS MENS GOLF LEAGUE 2012

NAME__________________________________BIRTHDATE _________Month/Day

ADDRESS __________________________________________________________

(STREET) (CITY) (ST) (ZIP)

PHONE # ____________________ EMAIL _______________________________

NEW MEMBER HDCP ________

Please print out, fill out and return with $50.00 Membership Fee payable to:

Fairways Golf & Country Club

SEND TO:

Joe Lightkep / mens league

Fairways Golf & Country Club

750 Country Club Lane

Warrington, PA 18976