2003
KENT & QUEEN ANNE'S HOSPITAL
SPORTING CLAYS TOURNAMENT

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Registration Information

 For Sponsors:

Sponsor's Name (as sponsor would like it to appear)     Contact    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone #    Fax #    E-mail     Sponsorship Opportunities: Corporate Sponsor  $5,000 Gold Sponsor  $2,500 Silver Sponsor  $1,000 Bronze Sponsor  $500 Station Sponsor  $250 Hospitality Tent Sponsor  $100 Prize Sponsor  $50 Junior Event Sponsor   All donations welcome! In kind donation     Describe your prize and its value below:

For Participants:

Shooters @ $100.00 each Junior shooters @ $75.00 each Lunch for non-shooters @ $15.00 each   Beretta Shot Gun Raffle   @Raffle tickets are $5.00 each or 5 for $20.00  Enter Your Total Here   Please remember to check for accuracy

 Individual Participants' Information:

Participant 1 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only	Participant 2 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only
Participant 3 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only	Participant 4 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only
Participant 5 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only	Participant 6 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only
Participant 7 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only	Participant 8 Name    Address Line 1       Address Line 2  (apt, suite, etc.)    City    State     Zip Code    Telephone    E-mail    Competition      Instruction Only

Payment Information:

* Select Type of Card Visa      MasterCard              American Express      Discover *Name (as it appears on your card)      Credit Card Billing Address *Address Line 1    Address Line 2  (apt, suite, etc.)    *City    *State     *Zip Code    *Telephone     Fax      E-mail    *Card Number    *Expiration Date    *Your Registration Total:    Please confirm the amount you wish to be charged to your card.

You will recieve a confirmation E-mail in several days.

Kent & Queen Anne's Hospital is a not-for-profit, 501(c)(3) charitable organization providing inpatient, outpatient, emergency and obstetrical health care services.  Fed. I.D. #52-0679694