Waverly Woods  Golf Tournament

  To benefit

  NIH Charities

Golfer Registration Form

Waverly Woods Golf Tournament

Monday June 29, 2009

MUST BE COMPLETED AND SUBMITTED TO HEIDI GROLIG BY JUNE 8, 2009

Company Name: _______________________________________________________________________

Names of Golfers:                                                                                                                     USGA Index or Range of

                                                                                                                                                         Scores for 18 holes

                 Golfer #1 ______________________________________________________________________

                 Golfer #2_______________________________________________________________________

                 Golfer #3_______________________________________________________________________

                 Golfer #4_______________________________________________________________________

The day includes golf on a premier golf course, continental breakfast, raffle tickets, tournament contests, mulligans, wonderful “cook-out” lunch, on-course refreshments, golfing awards, great silent auction, and door prizes.

For information on this tournament and how you can get involved, please contact Heidi Grolig at 301-402-0193 or groligh@mail.nih.gov.

On behalf of Friends of the Clinical Center, we thank you.

IF REGISTERING MORE THAN ONE FOURSOME, PLEASE REPRODUCE FORM.

                                                                  ** $150 PER PLAYER**

Please send your registration form(s) and check made payable to “ R&W Foundation “ to:

Heidi Grolig, Executive Director

FOCC

P.O. Box 340139

Bethesda, MD 20827