400 per team, 4 person Scramble Saturday, April 9 – 8:00am

CASH PRIZES FREE KFC LUNCH $400 per team, 4 person Scramble Saturday, April 9 – 8:00am Cookeville Golf Club For more info, call Teen Challenge of the Upper Cumberland at 888-­‐688-­‐0470, ext 103 or visit TeenChallengeUC.org REGISTRATION FORM First Name______________________________________ Last Name_______________________________ Street Address___________________________________________________________________________ City__________________________________________ ST___________ Zip_____________________ Phone ____________________________________ Email___________________________________________________________________________________ TEAM NAME_____________________________________________________________________________ Circle Polo Shirt Size Golfer 1:____________________________________________________________ S -­‐ M -­‐ L -­‐ XL -­‐ 2X -­‐ 3X Golfer 2:____________________________________________________________ S -­‐ M -­‐ L -­‐ XL -­‐ 2X -­‐ 3X Golfer 3:____________________________________________________________ S -­‐ M -­‐ L -­‐ XL -­‐ 2X -­‐ 3X Golfer 4:____________________________________________________________ S -­‐ M -­‐ L -­‐ XL -­‐ 2X -­‐ 3X Please make checks payable and mail with registration form to: Teen Challenge of the Upper Cumberland 760 Rickman Rd Livingston, TN 38570 phone: 888-­‐688-­‐0470 fax: 888-­‐221-­‐4764 Email: [email protected]