Western Mennonite School
Team Registration Team Captain: Address: City: Phone: Email: Age (as of Sept. 7, 2013): Name: Address: City: Phone: Email: Age (as of Sept. 7, 2013): Name: Address: City: Phone: Email: Age (as of Sept. 7, 2013): Name: Address: City: Phone: Email: Age (as of Sept. 7, 2013):
State:
ZIP:
State:
ZIP:
State:
ZIP:
State:
ZIP:
# of adult golfers:
x $95 =
# of student golfers:
x $75 = Donation:
Total Enclosed: Make checks payable to Western Mennonite School. Mail form and payment to: Western Mennonite School, Attn: Golf Benefit, 9045 Wallace Rd NW, Salem, OR 97304.