3rd Annual Blue Goose Golf Invitational
RESCHEDULED: MONDAY, NOVEMBER 7th, 2016
8:30 AM Registration, Driving Range & Putting Green open
10:00 AM SHOTGUN START

Carrollwood Country Club
13903 Clubhouse Drive
Tampa, FL 33618
(813) 961-1369

**Registration is $100.00 per player or $400.00 per foursome**

  Golfer NamesCompany    Email  Phone

1. ________________  _______________ ________________ ________________

2. ________________  _______________ ________________ ________________

3. ________________  _______________ ________________ ________________

4. ________________  _______________ ________________ ________________

REGISTRATION INCLUDES:  GOLF*BREAKFAST & LUNCH*BEVERAGES*PRIZES*BLUE GOOSE FELLOWSHIP

All proceeds will benefit the following:
The Children's Home, Inc. (EIN 50-0696284)
Friends of Joshua House Foundation, Inc. (EIN 20-0597719)

Please make checks payable to FLORIDA POND-BLUE GOOSE.  Please mail completed form and payment to:

David Neuhaus
Insurance Claims Unlimited
2625 Keystone Road, Suite A5
Tarpon Springs, FL 34688
Questions: Contact David Neuhaus at (727) 943-0407 or dneuhaus@goicu.com

OR

Register by credit card with PayPal:
Please complete and mail registration form to David Neuhaus per above indicating you paid via PayPal.

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