13th Annual

Sam Goss Memorial Golf Tournament

8:00 A.M. TEE TIME

Entry Fee: $180.00 Per Team

(Includes green fees, cart rental, tee prizes)

Team Flight Cash Prizes Awarded

For more information call:

Gabe Davis @ 816-797-6188 or Richard Ford @ 816-738-1935

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Entry Form

Team Members and Phone #:

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Please make your check payable to: Adrian Optimist Club

Send entry form and check to: Sam Goss Golf Tournament,

c/o Richard Ford, 304 Waggoner St., Adrian, MO 64720

PROCEEDS BENEFIT THE COMMUNITY PROJECTS AND YOUTH PROGRAMS SPONSORED BY THE ADRIAN OPTIMIST