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4th ANNUAL BUZZY LEVIN

GOLF TOURNAMENT

SUNDAY, SEPT 19, 2021

BLACKLEDGE COUNTRY CLUB

180 WEST STREET, HEBRON, CT 06248

FOUR PERSON SCRAMBLE, RAIN OR SHINE

12 PM REGISTRATION / 1 PM TEE OFF

DINNER & AWARDS BANQUET TO FOLLOW

$125 PER GOLFER / $450 PER FOURSOME

INCLUDES: GIFT, LUNCH, 18 HOLES, CART, PRIZES & DINNER

$30 PER PERSON FOR DINNER ONLY

$100 FOR TEE SIGN SPONSORSHIP

(FILL OUT FORM ON BACK PAGE)

GOLF TOURNAMENT ENTRY FORM

(PLEASE FILL OUT ALL INFORMATION FOR ALL PARTICIPANTS)

FULL NAME: ___________________________________________ HANDICAP: _________

ADDRESS: _________________________________________________________________

PHONE: ______________________________ EMAIL: ______________________________

FULL NAME: ___________________________________________ HANDICAP: _________

ADDRESS: _________________________________________________________________

PHONE: ______________________________ EMAIL: ______________________________

FULL NAME: ___________________________________________ HANDICAP: _________

ADDRESS: _________________________________________________________________

PHONE: ______________________________ EMAIL: ______________________________

FULL NAME: ___________________________________________ HANDICAP: _________

ADDRESS: _________________________________________________________________

PHONE: ______________________________ EMAIL: ______________________________

PLEASE MAKE CHECK PAYABLE TO: “GHTBL” - THEN SEND CHECK AND FORM TO:

MALLOVES JEWELERS, 404 MAIN STREET MIDDLETOWN, CT 06457

ALL PROCEEDS BENEFIT GREATER HARTFORD TWILIGHT BASEBALL LEAGUE

Page 2 of 2

4th ANNUAL BUZZY LEVIN

GOLF TOURNAMENT

SUNDAY, SEPT 19, 2021

BLACKLEDGE COUNTRY CLUB

180 WEST STREET HEBRON, CT 06248

TEE SIGN SPONSORSHIP FORM

ALL PROCEEDS BENEFIT GHTBL

NUMBER OF SIGNS: _____________ AMOUNT OF SPONSORSHIP: $______________

WORDING FOR SIGN: ______________________________________________________

_________________________________________________________________________

COMPANY/SPONSOR: ______________________________________________________

CONTACT PERSON: _________________________________________________________

MAILING ADDRESS: _________________________________________________________

PHONE: _______________________ EMAIL: ____________________________________

SPONSOR OUR 4

th ANNUAL BUZZY LEVIN GOLF

TOURNAMENT PLEASE ENCLOSE CHECK MADE PAYABLE

TO: “GHTBL” THEN SEND CHECK AND FORM TO:

MALLOVES JEWELERS 404 MAIN STREET

MIDDLETOWN, CT 06457

ALL PROCEEDS BENEFIT GREATER HARTFORD TWILIGHT BASEBALL LEAGUE