Name of Contact Submitting Registration *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Golfer #1 Information

First Name

Last Name

Birthdate

MM

DD

YYYY

Golfer #2 Information

First Name

Last Name

Birthdate

MM

DD

YYYY

Golfer #3 Information

First Name

Last Name

Birthdate

MM

DD

YYYY

Golfer #4 Information

First Name

Last Name

Birthdate

MM

DD

YYYY

Sponsorship & Participation Options

See pamphlet above for sponsorship details. Check all that apply.

Platinum Sponsor- $5,000

Premier Sponsor – $3,500

Snack Bar Sponsor – $3,000

Gold Sponsor – $2,500

Silver Sponsor – $2,000 (Golf not included)

Foursome – $1000

Individual Golfer – $300

Special Media Board Signage- $250

Cart Sponsor – $200

Banquet Only – $130

Would you like to purchase an ad in our Tournament Program?

If yes, please select one below. (Camera-ready art is due by August 8.)

Full Page Ad – $450

Half Page Ad – $400

Quarter Page Ad – $300

Business Card Ad – $150

Would you like to donate any of the following?

Check all that apply

Silent Auction Items

Goody Bag Item (Quantity: 200 per item)

Food/Beverage Item

ACKNOWLEDGEMENT & AGREEMENT

By submitting this form, I understand that my registration is not complete until payment has been received. After clicking "Submit," I will be redirected to the payment portal to finalize my registration.

I accept these terms.