The Great Putt-Putt Golf Challenge Entry Form to Make a Course Hole

Partnership for Floyd

PO Box 53

Floyd, VA 24091

Putt-Putt Golf Challenge Entry Form

Thank you for expressing an interest in being a part of the Great Putt-Putt Golf Challenge which will take place at the Floyd County High School Ballfields on July 2, 2011, from 4:00 – 8:00 pm. Set up will start at 1:30 pm. Judging will begin at 3:00pm. Awards, except for the Peoples Choice Award, will be presented at 4:00 pm. The People’s Choice Award will be presented later in the evening at the 4^th of July Celebration just prior to the start of the Fireworks. Following the awards, the “course” will be open to the general public to play. The “course” will be open to play until 8:00 pm. After which, dismantling and clean up of the holes may begin.

Entry Fee - $10 for pre-registered; $20 for registration the day of the event. Pre-Registration dead line is: June 27, 2011. Any registration post-marked after this date will be considered Day-of-the-event registration. Entry fees may be paid in advance or at the event; make checks payable to: Partnership for Floyd. Cancellations must be made by June 30, 2011. No refund will be given after this date.

Partnership for Floyd reserves the right to deny any application. In the event Partnership exercises this right, any entry fees received will be returned.

Entry registration forms may be sent to:

Putt-Putt Golf Challenge

c/o Dede McGrath

312 Long Level Road

Floyd, VA 24091

For information and questions, contact Dede McGrath at 540-745-5600 (leave message) or email at Deirdre.mcgrath@dvs.virginia.gov. Entry forms may be emailed.

Please complete, detach and submit form below:

Putt-Putt Golf Challenge 2011

Name: _________________________________________ Date: ___________________________

Business/Organization (if any): ______________________________________________________

Address: ________________________________________________________________________

________________________________________________________________________________

Email: _________________________________________ Phone: __________________________

Entry fee enclosed: ____ No ____ Yes $________ (Make checks payable to: Partnership for Floyd)

Hole description: May check more than one. (these may be reported on the day of the event if unknown at this time):

_____ Water Hazard _____ Sand Hazard _____ Other Hazard (List) __________

_____ Buffalo _____ Par _____ Rube Goldberg-Dr. Seuss design

Mail to: Putt-Putt Golf Challenge, c/o Dede McGrath, 312 Long Level Rd, Floyd, VA 24091