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Tournament Sign-Up Form
Autumn Scramble 
Saturday, November 3
 

1. Completely fill-out information for all golfers.

2. Click the Submit button.

3. Call the pro shop (610 845-2491) with your credt card information. 
Checks can be mailed to: Butter Valley Golf Port, PO Box 207, Bally, PA 19503
Note: Checks and credit cards will be processed the day before the event.
There will be no refunds for less than 4 players the day before or the day of the event.

Full payment is due 7 days before date of tournament. 
(Tee times or starting hole will be assigned according to date payment is received.)

Golfer # 1  

Golfer # 2

Name  

Name  

Address  

Address  

City  

City  

State  

State  

ZIP  

ZIP  

Telephone  

Telephone  

Customer #  

Customer #  

        
Golfer # 3  

Golfer # 4

 
Name  

Name  

Address  

Address  

City   City  
State   State  
ZIP   ZIP  
Telephone   Telephone  
Customer #   Customer #  
       

Your Email Address:

 
Autumn Scramble 
Saturday, November 3
 
Thank you for registering on-line. Please remember, payment is due at least 7 days before date of event. 

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