Association of insurance adjusters and associated service providers
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Golf Team Registration Form

GOLF TEAM REGISTRATION FORM

When:
Friday, April 11, 2014
Registration begins at 7:30 a.m.
Shotgun Start at 8:30 a.m.
Where:
The Eagles Golf & Country Club
16101 9 Eagles Dr., Odessa, FL 33556
813) 920-6681
www.eaglesgolf.com

**Continental Breakfast and Range Balls for early birds**
Registration Costs for Players
One player of a foursome must be a member in good standing to register

$95.00 per person for West Coast Claims Association members only by April 2, 2014.
$105.00 per person for non-membersby April 2, 2014.
$125.00 per person for member or non-member registrations receivedafter April 2, 2014

Please complete the below information and the amount of money from each player

Player #1 —Name:

Player #2 —Name:

Player #3 —Name:

Player #4 —Name: a

Total Amount:
$
Team Contact Person:

Phone:

Email:

All team moneys are due by April 2, 2014!
Please make checks payable to:
West Coast Claims Association and mail to:
8307 Temple Terrace Hwy, Tampa, Fl 33637

If you have any questions, you may contact any of the following persons:

Ted Coppola W.C.C.A. President
(727) 688.5294
Joel Schoenborn
Golf Committee Chair
(813).985.4330
Ron Breijo
(813) 286-1984

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