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$2,500 GRAND PRIZE LAFD INVITATIONAL


MOUNTAINGATE COUNTRY CLUB MONDAY, SEPTEMBER 19, 2016


BENEFITTING 3RD PRIZE DONATION


$10 per ball $20 for 3 balls $50 for 7 balls $100 for 20 balls


Entries must be received by MONDAY, September12th, 2016


WEARABLE CAMERA 4TH PRIZE FIRST IN OR CLOSEST TO THE HOLE 2ND PRIZE


Winner Need Not be Present to Win Participants will receive ticket stubs by mail prior to event


PAYMENT INFORMATION First Name:


Card Holder’s Address: Card Holder’s Phone:


Home Work


Home Cell


Work Visa MC AMEX Discover Credit Card No: Check Enclosed (Payable to Widows, Orphans & Disabled Firemen’s Fund) Signature:


MAIL TO: Widows, Orphans & Disabled Firemen’s Fund ATTN: Juliet Brandolino - PO Box 41903 - Los Angeles CA 90041 (323) 259-5215


Last Name: City: Email: Exp. Date: *CVV2 No: (*Required)


TOTAL AMOUNT: State:


Zip:


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