Golden Eagle Golf Course at the Tides Inn, Irvington, VA Friday May 14, 2010  

The 17th Annual Jacob's Ladder Golf Classic
Early Bird Registration Form   large product photo

FORMAT: 4 Person Team, Preferred Drive
Play own ball thereafter -- two best scores
Registration opens at 10:30am
Contest Begins at 11:00 (chipping & putting)
~ Shotgun Start at 12:30 ~

$150.00 per person to benefit the children of the Jacob's Ladder Enrichment Program...

100% of the net proceeds from the Golf Classic goes towards room & board!

YES, sign me up for how many team(s)?

No. 1
Name:
Address: City:
State: Zip: Email:

No. 2

Name:
Address: City:
State: Zip: Email:

No. 3

Name:
Address: City:
State: Zip: Email:

No. 4

Name:
Address: City:
State: Zip: Email: