* = Required Field

First Name *

Last Name *

Company Name

Address *

Apartment/Unit

City *

State:
Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code *

Email *

Phone *

Extension

Number Attending * (Select "0" below if you are not Golfing and ONLY Sponsoring)
0 (Not Golfing, Only Sponsoring)
1 @ $85
2 @ $170
3 @ $255
4 @ $340
5 @ $425
6 @ $510
7 @ $595
8 @ $680
1 @ $40 (Not Golfing, Happy Hour Only)
2 @ $80 (Not Golfing, Happy Hour Only)
3 @ $120 (Not Golfing, Happy Hour Only)
4 @ $160 (Not Golfing, Happy Hour Only)
5 @ $200 (Not Golfing, Happy Hour Only)
6 @ $240 (Not Golfing, Happy Hour Only)
7 @ $280 (Not Golfing, Happy Hour Only)
8 @ $320 (Not Golfing, Happy Hour Only)

Sponsorship * (See next field below, Select "No Thank You" if not Sponsoring)
No Thank You
Firefly for $100
Star for $200
Lunar for $300
Massage Chair for $375
Beverage Cart for $1500

SPONSORSHIP AND/OR LIST OF GOLFERS:
If Sponsoring, Please specify what you would like printed on your sign(s) for Holes(s), Chair or Cart
Examples: John Smith, Joe's Pizza, Go Glow Golfers - Compliments of Morgan Accounting
If Golfing, you may list the players in your group here

Total Amount *

Payment Method *
Check/Money Order (Pay at Event or in Person)
Credit/Debit Card