Name:

Address:

City:                                                            State:                                                Zip Code:

S.S #                                                          E-mail Address:

Signature

Phone:                                                Cell:                                            Housing:          Yes          No

***  All information must be filled out in order to be entered into our event

Do you plan to attend "Meet Your Team" on Friday July 9th?          Yes              No

Pros are encouraged to attend.  Complimentary Keg & Hor'dourves will be served.

Contact Damon Rusk to set-up your housing if needed:   605-310-9386

Exempt Pro Deadline - June 6

ENTRY FEE:  $750.00

After June 1st:  $800.00

Make Checks Payable to:  Bakker Crossing Charity Pro-Am

Entries will not be accepted without payment and social security number.

Send entry form and make checks to:

Bakker Crossing Charity Pro-Am

47172 Clubhouse Road

Sioux Falls, SD 57108

Attn: Pro - Am