Online Registration for the Lumberjack Scramble Golf Tournament, Security BankUSA

Friday, August 10, 2012
Entry Fee: $85 ($95 day of event)
Either register as a single player or a 5-person team.
* = required field

~TEAM REGISTRATION
	Team Leader Information
Team Leader Name:*
Leader's Day Phone:*
Leader's Night Phone:*
Leader's Address:*
City:*
State:*
Zip*
E-Mail
Handicap:
Starting Time Preferred:	7:30 am 1:00 pm
Total # of Carts?
Total # of Caddies?
	Player 2 Information
Player 2 Name:
Day Phone
Night Phone
Address
City
State
Zip
E-Mail
Handicap
	Player 3 Information
Player 3 Name:
Day Phone
Night Phone
Address
City
State
Zip
E-Mail
Handicap
	Player 4 Information
Player 4 Name:
Day Phone
Night Phone
Address
City
State
Zip
E-Mail
Handicap
	Player 5 Information
Player 5 Name:
Day Phone
Night Phone
Address
City
State
Zip
E-Mail
Handicap
	If you do not have a full 5 person team – there will be players “Filled In” the open slots

Proceeds from the Lumberjack Scramble are donated to the Bemidji Lumberjack Foundation and benefit Bemidji High School and Middle School activities. The tournament started in 1995 has raised more than $240,000.
List of "Where the $$$'s Go"

~SINGLE PLAYER REGISTRATION
Name:*
Phone Day:*
Phone Night:*
Address:*
City:*
State:*
Zip:*
Email:
Handicap:
Caddy? (extra fee)	Yes No
Starting Time Preferred:	7:30 am 1:00 pm
Power Cart? (extra fee)	Yes No