FAIRWAYS GOLF LEAGUE 2011

GOLFER ___________________________________________

BIRTHDATE________________(mo/day)

ADDRESS _____________________________________________________________

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

PHONE #_______________________________________

EMAIL_______________________________

(IMPORTANT TO RECEIVE CORRESPONDENCE)

Please print out, fill out and return with $37.00 per golfer Membership Fee payable to:

Fairways Golf & Country Club

SEND TO:

Fairways Golf & Country Club

ATTN: Leagues

750 Country Club Lane

Warrington, PA 18976