Registration for Chip Strong Memorial Golf Tournament

Contact Information

Fill these out even if you are not signing up with a team

First Name:

Last Name:

Address:

City:

State:
Alabama 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

Daytime Phone:

Email Address:

Sponsorships

Name on Sponsorship:

I would like to donate:

Additional Notes:

Event Information

Number of Golfers:
Select 1 2 3 4 5 6 7 8 Not playing  ($125 per golfer)      Entry fee WAIVED up to 8 playersEntry fee WAIVED up to 4 players

Mulligan Package:
Please check with team members to make sure you do not purchase multiple mulligan packages per team.
Select none ($0) for one team (+$40) for two teams (+$80)

Total Due:

Cardholder Information

First Name:

Last Name:

Address:

City:

State:
Alabama 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

Phone Number:

Email Address: