1. 1st Annual Kevin R. Freeman
Memorial Scholarship
Jeff Ashdown Brendan Whalen
(845) 591-9843 Golf Tournament
Co-Chairman Co-Chairman
(845) 389-4112
GOLF TOURNAMENT ENTRY FORM
DATE: May 21, 2012
TIME: Driving Range opens at 7AM
Registration/Continental Breakfast opens at 8AM
Shotgun Start at 9AM
PLACE: Casperkill Country Club Golf Course
2320 South Road
Poughkeepsie, NY 12601
ENTRY FEE: $125.00(includes: driving range at 7am, green fees, golf cart, continental
breakfast, lunch, and dinner)
*Payment Due by Friday April 20, 2012.
* Make Checks Payable to Kevin R. Freeman Scholarship Fund and mail to:
Kevin R. Freeman Scholarship Fund Golf Tournament
c/o Mobile Life Support Services Inc.
P.o. Box 471 Newburgh, NY 12550
Format: Tournament will be played with 4-person teams.
Cancelation Policy:
1. If golf tournament is canceled due to weather, the Golf Course has guaranteed a rain date however no date
has been provided as of yet.
If player cancels, please notify one of the Event Chairmen kindly 24 hours in advance. Entry Fee is not
refundable.
2. If a player is a “no-show”, entry fee is non-refundable.
Please complete the entry form and mail the form & entry fee to address above. Thank you for participating.
KEVIN R. FREEMAN MEMORIAL SCHOLARSHIP GOLF TOURNAMENT ENTRY FORM:
NAME: __________________________________________
ADDRESS: __________________________________________
__________________________________________
HOME PHONE: __________________________________________
CELL PHONE: __________________________________________
EMAIL: __________________________________________
YOUR SHIRT SIZE: S M L XL 2X
Other Team Members:
Player 2 Name: ____________________________________
Player 3 Name: ____________________________________
Player 4 Name: _____________________________________
* Please have each team member fill out an entry form. You may however send all 4-entry fees together. Total
should be $125.00 for 1 entry or $500.00 for all four team members. *