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Lynchburg Claims
Association
18th Annual Golf Outing in memory of
Ray Gilbert and Jimmy Thompson
All Proceeds Benefit the LCA Scholarship
and LCA Community Fund
Once again the Lynchburg Claims Association will have its golf outing at Poplar Grove Golf Course in Amherst, VA.
Poplar Grove is Sam Snead’s final design effort. It reflects a culmination of a lifetime in championship golf. Carved
through native Virginia forest, the layout features rolling terrain, natural streams and lakes, and sweeping
mountain views. For more information and directions, please visit www.poplargrovegolf.com
Thursday, May 17, 2018 Questions: please contact
Gary Barkman (276)494-4047
Registration opens at 8:30 AM gbarkman@hanover.com: or
Bill Farmer(434)610-3392
Shotgun Start at 10:00 AM wfarmer@servprooflynchburg.com
Option Description Cost
• Golf package includes greens fee, cart fee, mulligans, goodie bag, box lunch, entry for all
door prizes, and meal following golf.
Team Name________________________________ Golfers ____________________________________
Captain ___________________________________ ____________________________________
Telephone _________________________________ ____________________________________
Email _____________________________________ ____________________________________
Make Checks Payable to: Lynchburg Claims Association. Registration form and checks can be mailed
to: Hanover Insurance ATTN: Gary Barkman PO Box 2226 Forest, VA 24551. Anyone wishing to donate
door prizes should contact Gary Barkman or Bill Farmer-contact info above.
Tax ID/EIN # 47-3672773
Indicate all that
Apply
Hole Sponsor
Signage at Tee Box or
Green and Name on
Sponsorship Banner $150.00
Hole Sponsor
with Golf
Hole Sponsor as above and
four(4) golf packages $420.00
Team Entry Four Golf Packages $300.00
Single Player One Golf Package $80.00
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