REGISTRATION FORM Proudly Presented by: Proudly Presented by: Wednesday September 10, 2014 - 1:00 p.m. Shotgun Start Medicine Hat Golf & Country Club Date: Office use: Company : Address: City: Prov: Contact: Title: Phone: Cell: Fax: Email: PC: Registration $800 per team or $200 per person Total One Registration Form Per Team Team Name $800 Individual Name $200 Individual Name $200 Individual Name $200 Sponsorship See Below TOTAL (Tee off times will be issued on a first come first serve basis) Registration and Lunch at 11:30 a.m. - Tee Off Time 1:00 p.m. 1. Handicap Names Please make cheques payable to "Golf for Kids" 2. 3. 4. Sponsorships Available All Sponsors receive *Signage c/w Logo *Lunch *Dinner *Recog. in News Thank You Ad. Available Headline Sponsor 1 Banquet Sponsor 1 Cost Sponsorship $10,000 Includes 2 team entries plus name/logo on all marketing material $4,000 Includes 1 team entry and recognition and signage at the banquet. $25,000 Hole In One Sponsor 2 $2,000 Includes 1 team entry and insurance is handled by the tournament. Hole Sponsor 13 $2,000 Includes 1 team entry. Sponsors may promote at their hole. Longest Drive Sponsor 2 $2,000 Includes 1 team entry and prize to be awarded for the winner. Closest to the Pin Sponsor 2 $2,000 Includes 1 team entry and prize to be awarded for the winner. Golf Cart Sponsor 1 $2,400 Includes 1 team entry and professional signage on each cart. Hospitality Hole Sponsor 3 $3,000 Includes 1 team entry and one beverage/food item for every golfer. Method of Payment: Amount Please forward this registration to: ○ My cheque is included (payable to "Golf for Kids") [email protected] ○ My cheque will follow within 10 days ○ Charge to credit card ○ Visa ○ MasterCard ○ AMEX # Expiry: CVV (see attached):_____ For more information, please call: Postal Code assoc. with CC: Jim van der Sloot 403.548.9630 NAME: Connelly Sherwick 403.952.7859 X Credit Card Authorized Signature Adam Turnbull 403.526.6644 ext. 335 Clarence Heringer 403.548.4653 Phil Turnbull 403.526.3219 ALL PROCEEDS BENEFIT THE MEDICINE HAT CHAPTERS OF KIDSPORT & JUMPSTART What is the CVV?