Text Box:                         Individual or Team Entry Form Space is limited, payment in full is due no later than May 29, 2009 Make check payable to:  CSBV Golf Tournament   or Charge to my credit card:   _____VISA   ____ MasterCard                                                          CC # _______________________  Exp. Date __________ _____________________________  Signature                                           ——-                                                              $95. per person Applicant’s Name___________________________________ Address___________________________________________ City______________________State______Zip___________ Phone (H)___________________ (Work)________________ Email_____________________________________________   _______________________________________________________   Applicant’s Name___________________________________ Address___________________________________________ City______________________State______Zip___________ Phone (H)___________________ (Work)________________ Email_____________________________________________   _______________________________________________________   Applicant’s Name___________________________________ Address___________________________________________ City______________________State______Zip___________ Phone (H)___________________ (Work)________________ Email_____________________________________________   _______________________________________________________   Applicant’s Name___________________________________ Address___________________________________________ City______________________State______Zip___________ Phone (H)___________________ (Work)________________ Email_____________________________________________

Text Box:  Player Registration Form

Text Box: To contact us:

Text Box: Phone: 401 722 4626 Fax: 401 727 2967 Email: childrensshelter@cox.net