CHICAGO RIDGE PARK DISTRICT
US OPEN 2009 - July 11-12, 2009
PLAYER REGISTRATION FORM
BALL FORE Miniature Golf Course
6701 W. 107th Street, Worth IL 60482 - 708-423-3959
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LAST NAME
FIRST NAME
NICKNAME
DATE OF BIRTH
HOME ADDRESS
CITY
STATE
ZIP
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DAY PHONE
NIGHT PHONE
EMAIL ADDRESS
PAYMENT METHOD (Please check that which applies):
ENTRY FEES
OPEN
$100.00
Check/Money Order
Please make check or money order payable to:
WOMEN'S
$20.00
CHICAGO RIDGE PARK DISTRICT
SENIOR'S
$20.00
Mailing Address:
AMATURES
$25.00
9807 S. Sayre Avenue
Chicago Ridge, IL 60415
Attention: ILLINOIS STATE OPEN
JUNIORS
$5.00
TWO-PERSON TEAM
$20.00
Credit Card
(Visa or Mastercard Only)
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Credt Card Number
Expiration Date
Name on Credit Card
Three digit code on back of card
Shirt Size
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medium
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