______________________________________________ ______________________________________________ _________________________Captain Player #1 Email Address Daytime Phone

______________________________________________ ______________________________________________ _________________________Home Address City/St/Zip Evening Phone

______________________________________________ _______________________________________________________________________Player #2 Email Address

___________________________________________________ ________________________________________________________________________________Player #3 Email Address

__________________________________________________ _________________________________________________________________________________Player #4 Email Address

______________________________________________ _______________________________________________________________________Credit Card # Expiration Date Cardholder Signature

St. Charles, IL 60171Phone:630-584-4914 FAX:630-584-4595

www.pheasantrungolfresort.comRegistration Form

Registrations are being accepted at the pro shop. NO PERSONAL CHECKS ACCEPTED

Registration will not be accepted without payment! NO EXCEPTIONS

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Four person scramble. This will be a Jekyll/Hyde format. 9 holes will play as easy as possible and 9 holes will be the most difficult set-up we can produce. Teams will

be flighted based on their 18 hole score. There will be multiple winners.Saturday, October 14th, 2017 - Registration 8:30 a.m. - Shotgun Start 10:00 a.m.

$85.00 per person, $340 per team Includes Green Fees, cart, prize funds, and dinner after the round.

**Optional Cash Skins Game Available**

Entries Close Friday,October 13th at 5:00 p.m.** All players must pre-pay

Cancellation Policy: No refunds within 24 hours

FALL SCRAMBLE