Erie County Parks, Recreation and Forestry 2017 Golf Permit Application

County Executive – Mark C. Poloncarz

Commissioner of Parks- Daniel J. Rizzo

Erie County Parks, Recreation and Forestry 2017 Golf Permit Application My 2016 pass number is _________. If you did not have a pass last year, you must call 858-7037 to arrange to apply in person. Choose one Code Cost Description of Permit: _____ 1000A $300.00 Grover Cleveland Regular _____ 1000B $230.00 Grover Cleveland Senior/Youth _____ 2000A $340.00 Grover Cleveland Regular w/ T-Time _____ 2000B $275.00 Grover Cleve Senior/Youth w/ T-Time _____ 3000A $420.00 Elma/Grover Regular _____ 3000B $320.00 Elma/Grover Senior/Youth _____ 4000A $460.00 Elma/Grover Regular w/ T-Time _____ 4000B $365.00 Elma/Grover Senior/Youth w/ T-Time _____ $ 10.00 Replacement (lost) Card Fee (a new # will be issued) Name ____________________________________________________ Address ___________________________________________________ City, Zip __________________________________________________ Total Due _________________________________________________ Date of Birth_______________________________________________ E-Mail ____________________________________________________ Phone_____________________________________________________ Senior Pass holder must be 62 or over, Youth Pass holder must be 16 or younger. Golf Passes are non-refundable. Make Checks Payable to “Erie County Parks.” Mail Application and Check to: Erie County Parks 95 Franklin St Rm 1260 Buffalo, NY 14202