Louisiana Scratch Tour

_{P.O. Box 256}

_{Covington, LA 70434-0256}

Sandestin Golf and Beach Resort Golf Outing Application

Room & Course Charge: $399.00

Tournament Charge: $100.00 (All monies to be paid out)

$200 Deposit due by Nov 1st to be mailed with this application. Balance to be paid on arrival.

_{Type in information print and mail application along with deposit to the above address}

Participant Information

First Name:    Last Name:

Address:

City: State:   Zip:

Home Phone: Work Phone:  

Please include area code on all phone numbers

Email Address:

Age:   Date of Birth: HDCP:

Course Affiliation: