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            Eighth Annual DeCesaris/Prout

                Championship Golf Tournament

               Twin Shields Golf Club - Friday, June 25, 2010

Luncheon Only Registration Form

A reception follows the golf tournament, which includes a delectable lunch catered by Bayside Bull and music provided by Crow Entertainment. The reception also features a large silent auction with an array of wonderful items for guests’ bidding pleasure. For those individuals who are not participating in the golf tournament, a $40 “luncheon only” donation is requested. The luncheon will begin at approximately 1:30 p.m.

Donor Name:  ___________________________________________________

Address:          ___________________________________________________

City/State/Zip:            ___________________________________________________

Daytime Phone:          _____________________      E-mail: ____________________

 I would like to make luncheon reservations for ______  x $40 = Amount Enclosed: _________

Please use the spaces to below to identify additional lunch guests:

1.)      _____________________________________                                

2.)      _____________________________________                                

3.)      _____________________________________                                

4.)  ______________________________________