Hillsborough County Sheriff’s Office

9th Annual Charity Golf Tournament

Benefiting: The Boys & Girls Clubs of Tampa Bay


Yes, we will participate in the 9th Annual Hillsborough County Sheriff’s Office, Boys &
Girls Clubs of Tampa Bay, Charity Golf Classic on November 19, 2010.

Sponsorship Level:
Eagle sponsorship $800.00 (one team)
Builder Sponsorship $1500.00 (two teams and additional benefits)

No, we will not be able to participate, but have chosen to make a donation of $__________,
Or will contribute the following type of donation:

 Food & Beverage  Raffle Prizes

 Auction Items  Other:

Individual/Company Name:

Contact Person:

E-mail Address:

Mailing Address:

City: State: Zip Code:

Telephone Number: Fax Number:

Tournament Information Make checks payable to:

Hillsborough County Sheriff’s Office Charities, Inc.
Emerald Greens Golf Resort & Country Club Mail to: Hillsborough County Sheriff’s Office
13903 Clubhouse Drive Attention: Deputy Jerry Carey
Tampa, Florida 33618 Post Office Box 3371
Tampa, Florida 33601-3371

Registration: 10:00am – 12:00pm  Tee Time: 12:00pm sharp

See Reverse for Team Information

 Player 1

Title: First Name: Last Name:

Telephone Nbr.: Email Address:
Mailing Address:
City: State: Zip Code:
Shirt Size: ML XLXXL Handicap:

Player 2

Title: First Name: Last Name:

Telephone Nbr.: Email Address:
Mailing Address:
City: State: Zip Code:
Shirt Size: ML XLXXL Handicap:

Player 3

Title: First Name: Last Name:

Telephone Nbr.: Email Address:
Mailing Address:
City: State: Zip Code:
Shirt Size: ML XLXXL Handicap:

Player 4

Title: First Name: Last Name:

Telephone Nbr.: Email Address:
Mailing Address:
City: State: Zip Code:
Shirt Size: ML XLXXL Handicap:

HCSO Charities, Inc.

The Internal Revenue Service has designated HCSO Charities, Inc., as a public charity under section 501 (c) (3) of the Internal
Revenue Service Code. Contributions to HCSO Charities, Inc. are tax deductible under section 170 of the Internal Revenue Service
Code. Additionally, bequests, devises, transfers or gifts made to HCSO Charities, Inc., are tax deductible under section 2055, 2160
or 2522 of the Internal Revenue Service Code.
{Public Charity Status 170 (b) (1) (A) (vi), Employer Identification Number 20-1895808}

Payment
Checks should be payable to HCSO Charities, Inc.. Receipts and/or charitable acknowledgement letters are available upon
request. Reservations are booked only with receipt of payment.

Player Check-in/Registration
Player check-in/registration will open at 10:00 am. Handicaps must be provided at least one week prior to the tournament date.
Those players whose handicaps are not provided will be assessed a handicap of 1.

Inclement Weather Conditions

In the case of inclement weather, tournament directors reserve the right to cancel the tournament. Should inclement weather be
predicted for or observed on November 19, 2010, you may contact the Emerald Greens Golf Resort & Country Club Pro-Shop
(813-961-1381 ext. 133) to determine the tournament status.

Waiver of Liability
In consideration of my entry, I, my heirs, executors and administrators waive all claims, release from all liability, and agree to hold
harmless, HCSO Charities, Inc., Hillsborough County Sheriff’s Office, Boys & Girls Clubs of Tampa Bay, and Emerald Greens Golf
Resort & Country Club, Inc., its agents, members and sponsors of this event {9th Annual Hillsborough County Sheriff’s Office, Boys
& Girls Clubs Charity Golf Tournament} for any and all injuries and damages suffered by me in connection with this event. I
understand that the sport of golfing entails personal risk, including serious bodily injury and even death, and I assume that risk. I
recognize the physical exertion involved in the event and attest and certify that I am physically fit to compete safely, and have not
been advised otherwise by a health care professional.