Seafood Scramble Registration

Seafood Scramble Registration Form

When: October 17th

Registration Deadline: October 13th

Please mail registration payment to:

Jala Hayes
315 W. Hickory Street
Sylacauga, AL 35150

Make checks payable to Coosa Valley Medical Center Foundation or call 256-401-4070 to pay with a credit card.

    *Each Player fee includes: cart, tournament gift & Seafood Scramble buffet available from 11:30am-1:30pm.
  • Player 1 Information

  • Player 2 Information

  • Player 3 Information

  • Player 4 Information

  • For more information please contact Jala Hayes at 256-401-4070 or email at