5th Annual Golf Tournament
Place:     Sterling Farms Golf Course, Stamford, Connecticut

Date:      September 20, 2012

Format:  Shotgun Start at 1:45pm- Simple Scramble 

              Registration and lunch available at 12:00pm

Cost:      $150 per golfer (greens fees, carts, contests, lunch and dinner)

            Name               Address              City/State/Zip           Phone

1.         ________________________________________________________

2.         ________________________________________________________

3.         ________________________________________________________

4.         _________________________________________________________

Spots will be guaranteed on a first come first serve basis. Tournament is rain or shine.  All checks must be received by August 15, 2012.

Please make checks payable to:          The Randy Cappiello Foundation

                                                            PO Box 834

                                                            Ridgefield, CT 06877

Should you have any questions, please contact Keri Cappiello at keri_cappiello@yahoo.com