9th ANNUAL CHARITY
GOLF TOURNAMENT REGISTRATION


SPONSOR & FOURSOME
TOURNAMENT REGISTRATION FORM
Remember... the registration deadline is May 16th, 2003!

* These Fields Are Required to complete the form.

I/We would like to play in this year's tournament:
 *The Total Number of Golfers You Are Registering ($175 per person, $700 per foursome) 

*Your Name:
*Phone #:
*E-mail:
 Your Name:
Phone #:
E-mail:
 Your Name:
Phone #:
E-mail:
 Your Name:
Phone #:
E-mail:

Team Sponsor's Name: 

   Golfer's registration includes green's fee, cart, snacks and beverages on the course, lunch, one ticket to the awards reception, complimentary beer and wine, and a charitable donation.
Tee Time Preference:   
 8:00am   1:30pm 

    **You will be contacted individually for handicap and club affiliation information.
 Sponsorship Opportunities:

Not a Sponsor  
Corporate Sponsor  $5,000
Gold Sponsor  $2,500
Silver Sponsor  $1,000
Bronze Sponsor  $500
Hole Sponsor  $250
Event Sponsor  
I would like my sponsorship to be used for:
Diagnostic Cardiac Cath
Education
Emergency Services
Equipment
M.R.I.
Oncology
Surgical Services
Where Needed Most
Closest to the Pin ($100 minimum value)  
Longest Drive in the Fairway
Men's Ladies'
Longest Drive out of the Fairway
Men's Ladies'
Most Accurate Drive
Team Prize (4 players)
Door Prizes
Other
  Please describe your prize here:

 Reception

We welcome non-golfers to the after tournament reception in the Clubhouse. (Golfers each receive one admission with their paid registration)
            Tickets to the reception for all non-golfers are $40 each (specify number of reception attendees)
Please list the NON-GOLFING attendees to the reception below:
Reception Attendee 1 Reception Attendee 2 Reception Attendee 3 Reception Attendee 4

Reception Attendee 5		 Reception Attendee 6 Reception Attendee 7 Reception Attendee 8


*Payment Information (please select type of card)
Visa      Master Card      American Express      Discover Card     

Sponsor's Name
*Name (as it appears on your card)
*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 private, not-for-profit, 501(c)(3) charitable organization providing inpatient, outpatient, emergency and obstetrical health care services.  Fed. I.D. #52-0679694