Chamberlain Golf
PAIRS SCRAMBLE Tournament
Saturday, August 21st, 2004
Glenwild Greens is a 9-hole Par-3 Golf Course

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Please print this form (one per team) from your web browser and complete all information below, including parent/guardian signature for minors and mail with check payable to "Chamberlain Golf":
CHAMBERLAIN GOLF
8 Fieldstone Drive
Kinnelon, NJ 07405
973-838-3574
Entry Fee $30 per team
Tournament will be held at:
    Glenwild Greens GC
    102 Glenwild Avenue
    Bloomingdale, NJ 07405
One caddie (age 14 or older) per team permitted.  Teams are expected to report to the starter at least 20 minutes in advance of their assigned tee time.  Play will start and/or continue in the event of light rain.  Entry deadline is the Sunday, August 15th.  Acceptance of late entries cannot be guaranteed.  Please keep a copy of this form for reference - you will not receive a confirmation.  You may call the course at 973-283-0888 Mon-Fri between 9:00-4:00 to confirm your entry.  Starting times  will be posted on www.glenwildgreens.com by Wednesday, August 18th. Scoring method: SCRAMBLE FORMAT
Starting times will be assigned as early as 7:30am
Captain                                                                                                                  Age (if under 18)
Player 2                                                                                                                  Age (if under 18)
Address
City                                                                                        State                         Zip
E-mail
Home phone                                                                         Cell
Team Category:
q Junior-Junior (both entrants 17 or under)
q Adult-Junior (e.g. Parent-Child, Uncle-Niece, etc.)
q Senior-Junior (e.g. Grandparent-Grandchild, etc.)
q Adult-Adult (e.g. Husband-Wife, Friend-Friend, etc.)

Please complete this section for minors only:

I, the undersigned parent or guardian of _________________________ do hereby agree to forever refrain from making claim or bringing suit against the Glenwild Greens Golf Course (GG), Chamberlain Golf (CG) or any of their agents, servants, or employees and do further release and hold harmless GG and CG or any of their agents, servants, or employees on account of any and all claims, demands, damages, costs, loss of services, expenses, pain and suffering or personal injury arising out of any act or omission whether negligent or not while the above named minor is participating in any activity sponsored by GG or CG.

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print parent/guardian name                                                    parent/guardian signature