Palatka Fire Department

5th Annual Lafarge Fire Prevention Golf Tournament

                              Sponsored by:

Date: March 26, 2011                              

Place: Palatka Municipal Golf Course- 1715 Moseley Ave, Palatka, Fl 32177
Time: Registration/ breakfast 7:30                   9:00 shotgun start

Fees: $75.00 (per player) 4 man scramble

Entry fee includes cart & green fees, Full breakfast, lunch, shirt, goody bag and door prizes. Additional door prize tickets and
50/50 tickets can be purchased at the tournament.

1^st place $500.00 -  2^nd place $300.00  -  3^rd place $200.00

Additional place prizes:  4^th, 5^th, 10^th, 15^th, 20^th, 25, and last place.

5 - $100.00 Hole prizes.  #2, #3, #12, #14, #16 hole prizes

Tournament limited to the first 26 teams to register

Team Members

- Please print names -                                                                    - Shirt size -

Player 1- ___________________________________/___________

Player 2- ___________________________________/___________

Player 3- ___________________________________/___________

Player 4- ___________________________________/___________

Team Captain & contact number:______________________________

Make checks payable: City of Palatka, memo: Fire Pub-ed. Entries must be signed up and paid prior to
March 18, 2011.For information, contact Fire Marshal Mark Lynady at 386-329-0122 or 386-937-8277.
Send forms and checks to Palatka Fire Department 100 N 11^th St. Palatka, FL 32177  attention: Mark Lynady