GOLFER REGISTRATION
Player # 1
Registrant
PAYMENT INFORMATION
20th Annual
Name_________________________________________________________ Address_______________________________________________________ Telephone_____________________________________________________ E-Mail________________________________________________________ Jacket Size _____________________________________________________
My Check is Enclosed. Please make check payable to:
Benefit Golf Tournament
Massena Memorial Hospital Foundation
Please bill my credit card: VISA Master Card American Express Discover
Player # 2
Name_________________________________________________________ Address_______________________________________________________ Telephone_____________________________________________________ E-Mail_________________________________________________________ Jacket Size _____________________________________________________
Total Amount $__________________________ Card Account Number (16 Characters) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Name on credit card (Please Print) ————————————————————————————————————— Authorized Signature (Below) ————————————————————————————————————— Expiration Date:______/______/______
Player # 3
Name_________________________________________________________ Address_______________________________________________________ Telephone_____________________________________________________ E-Mail________________________________________________________ Jacket Size ____________________________________________________
4 Person Scramble
Divisions: Men’s, Women’s, Mixed (2 Men /2 Women) Thursday, August 28, 2008 Massena Country Club Major Sponsorship Provided By:
Player # 4
Name_________________________________________________________ Address________________________________________________________ Telephone______________________________________________________ E-Mail_________________________________________________________ Jacket Size _____________________________________________________
CONTACT US WITH QUESTIONS: Massena Memorial Hospital Foundation, Inc. Benefit Golf Tournament 1 Hospital Drive Massena, NY 13662
(315)
769-4273 or (315) 769-4602
(315) 769-4712 FAX jfowler@massenahospital.org jrose@massenahospital.org Check us out on the web: www.massenahospital.org
(Please Complete Front & Back sides before returning)
REGISTRATION/DONATION FORM
Thursday
August 28, 2008 Massena Country Club Schedule of Events
7:00AM—7:45AM
Registration for Morning Round Play
CONTACT PERSON: _____________________________________________ BUSINESS/ORGANIZATION: _______________________________________ ADDRESS: _____________________________________________________ PHONE: ___________________FAX: ___________________ E-MAIL___________________________________________ Preferred tee time: 8:00 a.m. Shotgun 1
. /21 by 8 d spon per se re fee, Plea ate n or 20 l apply o A $ will , team /22 r8 afte
1:30 p.m. Shotgun 2 3 4
Un-sponsored team (ask about self-pay discount) # of PLAYERS? Sponsored team(s) _______ at $320.00* per team ($80 per person)
*** Massena Country Club Members—ask for your special rate
8:00 AM
Tee-Off/Shotgun Start for Morning Play
* Includes Greens Fees ($30), Prizes, Door Prizes & a delicious Buffet Dinner—Carts are NOT included
12:30 PM—1:15 PM
Registration for Afternoon Round Play
*We have golfers, if you want to sponsor a team. We will advertise for you. YES ONE CART 2 CARTS NO NOTE: Please call Massena Country Club Pro Shop, 769-2293, for cart reservations.
DO YOU HAVE OWN CART?
1:30 PM
Tee-Off/Shotgun Start for Afternoon Play
Will sponsor ____ tee/greens at $175 each Will sponsor ____ tee with Trade Show Booth at $250.00 each Will donate prize or gift certificate:______________________________________________ Will send donation, as I am unable to play or sponsor. $ _____________________________
6:00 PM—6:45 PM
Cocktails
6:45 PM
Buffet Dinner &
Presentation of Prizes & Awards
Will only attend the delicious Buffet Dinner at 6:30p.m. _____ person(s).........at $15/person PLEASE MAKE CHECKS PAYABLE TO: MMH Foundation, 1 Hospital Dr., Massena, NY 13662