Mountain Lake Challenge Registration

2017 Mountain Lake Challenge Entry

Club Name

Player 1

Address

Email

Phone

Player 2

Address

Player 3

Address

Professional Name

Email

Housing

Colony House

Member Home

Other

Billing

Bill my club account

I will mail a check

I would like someone to call me for my credit card number

Checks should be mailed to: Jillian Schooley-Richardson, P.O. Box 832, Lake Wales, FL 33859

Phone number/Club account number/Notes

Please provide daytime phone number or any billing questions/comments.

Questions: Jillian Schooley-Richardson, jschooley@mountainlakecc.com or 863-679-2423