Registration Form - Through the Eyes of a Child Golf Outing - Friday, June 11th, 2004

This is a simple form without many scripts. In order to submit this form, please make sure that you are connected to your browser and email program. Once you click the SUBMIT button, an email will be sent to me and a copy placed in your SENT folder. If your email is not active, this form will not be sent.

After submitting the form, please RESET the form and close. Your confirmation that the form was submitted will be your copy of the email in your SENT folder of your email program. Once I receive the form, I will confirm the total cost and reply to your email address that you entered in the form.

Team Name
First Golfer Name
Shirt Size Small Medium Large XL 2XL Other
Address
City
State
Zip / Postal Code
Phone Number
E-mail Address
Second Golfer Name
Shirt Size Small Medium Large XL 2XL Other
Third Golfer Name
Shirt Size Small Medium Large XL 2XL Other
Fourth Golfer Name

Shirt Size Small Medium Large XL 2XL Other
Total Cost for Golfers
1 Golfer @ $95.00 2 Golfers @ $190.00
3 Golfers @ $285.00 4 Golfers @ $380.00
Guest Dinners
1 Guest Dinner @ $45.00 2 Guest Dinners @ $90.00 
3 Guest Dinners @ $135.00 4 Guest Dinners @ $180.00
If more dinners are required, please input total additional guest dinners in NOTE area below.
Payment to be:
At Registration Online via Credit Card Will Mail Check
If you wish to pay Online via Credit Card, please go back to the Golf Outing page, then click on the Registration button to complete the Secured Online Registration Information. If you complete this form, then you do not have to complete the Golfer Information located on the Online Registration form.
Notes or Comments