The MESS jack@themess.org

1^ST Player Name:_______________________________________

2^nd Player Name:________________________________________

3^rd Player Name:________________________________________

4^th Player Name:________________________________________

Company Name:________________________________________

Address:______________________________________________

City:____________________Zip:__________________________

Phone:________________________________________________

Email:________________________________________________

GoTo www.mississippidunes.com For Online Registration

_____Dinner & Gift Bag & Prize Raffle $40.00 each

          Dinner and Reception will start after all golfers have returned to the club house

          Select this option for non-golfers who want to attend the dinner and raffle
          (This is a nonrefundable event unless the event is canceled)

Proceeds to Benefit

CONTACTS:

The M.E.S.S

Cottage 55016

Tony Mahmood:
 651-226-2928                     

and

Jeremy Gay:
651-238-1534                           

Juvenile Diabetes

Jim Boudewyns:
 651-428-3738