4th Annual

Samantha Dodaro Golf Classic

To benefit

Families of spinal muscular atrophy

Being Held At:

Jurupa Hills Golf Course 6161 Moraga Riverside, Ca 92509 (909) 685-7214

Friday, October 8, 2004 

Activities begin at 7:30, Shotgun start begins at 9:00, Buffet Dinner  approximately 3:00 pm

Sponsor and Player Sign up Form:

Name: _______________________________

Address: ______________________________

_____________________________________

Phone: _______________________________

Qty Total

____Sponsorships Minimum $100.00 ______

____          Golf/Buffet dinner $75.00 ______

____         Buffet Dinner Only $25.00 ______

____               Additional Donations  ______

                      Total Enclosed $ _______

We will be playing rain or shine

Please Return Completed Form with check By September 1, 2004     Payable To:   FSMA

Mail To: Samantha Dodaro Golf Classic  P.O. Box 172, Calimesa, California 92320

For additional information please call: Wanda Dodaro (909) 312-5903 or Email: sdgolfclassic@yahoo.com  

Samantha’s Web Site: http://www.our-sma-angels.com/samantha/