2nd Annual Balloon sale

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Fee includes:

Green fees & cart

Buffet lunch provided by RiverRock Grill and Alehouse

Tee prizes, raffl e ticket and charitable contribution.

Release: In consideration of your accepting this entry, I the undersigned, intending to be legally bound, hereby for myself, my heirs, executors, administrator, and/or assigns, waive or release

any and all rights and claims for damages I may have against the City of Renton, IKEA Renton River Days Committee, Event Committee, and any other sponsors, directors or employees or

volunteers of the same (hereinafter the ³sponsors²), for any and all injuries suffered to me in this event, or during any transit to/from this event. Further, I hereby agree to hold harmless the

sponsors, from any claims of third parties arising out of my participation in this event or during my transit to/from this event. I attest and verify that I am physically fi t and that my physical

condition for participation in this type of event has been verifi ed by a licensed medical doctor during the last 6 months.

Name: ___________________________________________________Phone Number _________________________

Address: ________________________________________________________________________________________

Name: ___________________________________________________Phone Number _________________________

Address: ________________________________________________________________________________________

Name: ___________________________________________________Phone Number _________________________

Address: ________________________________________________________________________________________

Name: ___________________________________________________Phone Number _________________________

Address: ________________________________________________________________________________________

Make checks payable to: Renton River Days

Tournament Format:

Four Person Scramble

Shot Gun start at 8:00 a.m.

Only one low handicapper per team (10 or below)

Divisions to be determined based on the fi eld.

Help us keep Sam's commitment to the youth of Renton alive by participating in the Annual Sam Chastain Memorial Golf

Tournament. All proceeds from this tournament will benefi t The Sam Chastain Scholarship Foundation, Communities in

Schools of Renton and the Evergreen Chapter of the ALS Association. Your participation is appreciated.

July 23, 2010

Maplewood Golf Course ● 4050 Maple Valley Highway ● 425-430-6800

Return entry form with fee to:

Susie Bressan c/o Renton City Hall , 1055 South Grady Way, Renton, WA 98057-3232

9th Annual Sam Chastain

Memorial Golf Tournament

Fee per team is: $320

“ The School District does not sponsor,endorse,or recommend any of the organizations, services, or activities described in this information. This information is provided solely for

the convenience of our students and parents to assist in their review of the safety and suitability of such organizations, services and activities. “

Business Name: ____________________________________________________________________________

Address: _________________________________________City: _______________________Zip: __________

Contact Person: ____________________________________________Phone: __________________________

❐ Payment Enclosed ❐ Raffl e or Auction Item enclosed

❐ Please arrange to pick-up item by calling

Please respond by July 16. Make checks payable to Renton River Days and return to:

Help us keep Sam's commitment to the youth of Renton alive by participating in the this year's Sam Chastain Memorial Golf Tournament.

Proceeds from this tournament will benefi t Renton's Communities in Schools program, the Sam Chastain Memorial Scholarship

Foundation and the Evergreen Chapter of the ALS Association. Your participation is appreciated.

You, or your organization, can help in any of the following ways:

By donating an item to be given away as a tee prize or raffl e item

By donating an item to be auctioned in the silent auction

By purchasing a fairway sign displaying your company name and logo

Please join us in helping Renton area youth through Communities in Schools of Renton and the Sam Chastain Scholarship Foundatin

and area residents affl icted with ALS through the Evergreen Chapter. Any donation, no matter how small, would be appreciated.

For more information on how to donate, call Mike Toll at 425-430-6805 or Shirley Anderson at 425-430-6717.

❐ Returning sponsor fairway sign ($90.00)

❐ New sponsor fairway sign ($120.00)

Sign verbage as follows:

________________________________________________________

_____________________________________________________________

❐ Auction item of ____________________________________

❐ Raffl e item of _____________________________________

July 23, 2010 - 8:00 a.m. - Maplewood Golf Course

Susie Bressan

Renton City Hall

1055 South Grady Way

Renton, WA 98057-3232

Some editing may be done due to space constraints.

9th Annual Sam Chastain

Memorial Golf Tournament