1. 2012 INDIANA EMERGENCY RESPONSE 2012 IERC Golf Outing
Wednesday, September 12, 2012
Winding River Golf Course
8015 South Mann Rd
Four Person Scramble - 8:00 am Shotgun Start Indianapolis, IN 46221
Cost: $ 60 per person for Green Fees & Lunch
$ 240 for a Foursome www.windingrivergc.com
Hole Sponsors: Hole Sponsors: $ 125
Hole Sponsors and a Foursome: $ 340
Cart Sponsor $25 Your Sponsor signage on one of the golf carts
Prizes: 1st, 2nd, 3rd Place, Longest Drive, & Closest to Pin Title Sponsor Lunch Sponsor
Fire, EMS, Law Enforcement, Exhibitors and Spouses are cordially invited to
attend. Participants wishing to play the day before (9/12/12) should contact
the golf course directly at 317-856-7257.
Breakfast Sponsor
Registration
Participant Type Quantity Cost Total Foursome Deadline: 9/08/12
Single Participant $60 $ Sponsorship Deadline: 9/08/12
Foursome $240 $
*Sponsor Name (for signage)
Cart Sponsor* $25 $
____________________________________
Hole Sponsor* $125 $
Hole Sponsor + Foursome* $340 $ ____________________________________
Total $
*Sponsors, please email your company logo (in high-resolution jpeg or esp format) for signage to rake@indfirechiefs.org
Participant(s) Information and Payment (Print Legibly Please)
Name(s) 1. ____________________ Handicap ______ 2. ____________________ Handicap ______
3. ____________________ Handicap ______ 4. ____________________ Handicap ______
Fire Dept./Company ________________________________ Address ______________________________________________________
Phone/Email _______________________________ / _____________________________________________________________
Return this form with payment (check - payable to IFCA) to:
2012 IERC Golf Outing, P.O. Box 364, Zionsville, IN 46077
PH (317) 733-1850, Fax (317) 733-4212, Email: rake@indfirechiefs.org.
Team Coordinator: Chief Dale Henson of the Decatur Township Fire Department.
Please send a copy of this form to: Chief Henson at Decatur Township Fire Department, 5410 S. High School Road, Indianapolis, IN 46221
Ph (317) 856-5400, Fax (317) 856-1426, Email dhenson@decaturfire.org.
Payment: ___ Check Enclosed ___ Visa ___ MC CC # ______________________________________ Exp ______
Name on Card _______________________________Signature _________________________________
indianaerc.com •September 12—15 • Downtown Indianapolis