Registrations accepted online at www.fairfaxmed.com
or by mail to:
Community Hospital-Fairfax
Attn. Development Department
PO Box 107, Fairfax, MO 64446
Registrations are still being accepted. Teams will receive preference
based on PAID registrations.
Questions may be directed to the Development Office at (660) 686-2211 ext.
259 or anns@fairfaxmed.com.
Sponsor/Team Entry Form
19th
Annual CommuniTEE Benefit Golf Classic
August 27th & 28th, 2010, Mound
City Golf Club, Mound City, MO
Format is a best shot, four-person scramble.
Sponsor
I wish to support Community Hospital-Fairfax in the following manner:
0
TOTAL AMOUNT OF SPONSORSHIP =$
Please provide information as you would like it to appear in printed materials. Tax deferred donation determined on amount of sponsorship.
Name
City, State, Zip
Contact Person
Phone #
Golfer(s)
-
$100 Golfer Fee includes gift, green fees, meal ticket and Saturday evening
dinner ticket
-
Optional Bonus Package-$20 per golfer includes
2 Mulligans, 2 Longest Drive Contest, 2 Multi Pin Contest and 2 Putting Contest
tickets.
Address
Golfer Fee $100/ea.
*Bonus Pkg. $20/ea.
Addtl. Dinner guest $15
Total each Column
Golfer's Name
Address, City, State, Zip
Label
Label
Label
Label
TOTAL =$
Carts
0
TOTAL AMOUNT DUE
0
SATURDAY, Aug. 28
FRIDAY, Aug. 27
Tee off Time: (Earliest registration with payment receives preference.)
Email Address: