Name of individual or business: ___________________________
Address: ________________________________
City: _________________________
State: _____ Zip Code: _______________
Phone: __________________
Email: _______________________________________________
Team Name: _______________________________
Phone: ____________________
Players: 1 Player $110; 2 Players $220; 3 Players $330; 4 Players $440
1. Name: __________________________ Phone: ___________
HC/: ____ Email: _____________________________________
2. Name: __________________________ Phone: ___________
HC/: ____ Email: ______________________________________
3. Name: __________________________ Phone: ___________
HC/: ____ Email: ______________________________________
4. Name: __________________________ Phone: ___________
HC/: ____ Email: ______________________________________
Purchase:
____ Hole Sponsor $300 + ½ Page Ad in Golf Booklet
____ 1/3 Page Ad Golf Booklet - $75
____ ½ Page Ad Golf Booklet - $150
____ Full Page Ad Golf Booklet - $250
____ Mulligans- two free per Player. Extra $10 Each
____ Player(s) $110-$440) List Players Above
____ Inside Back Cover & Back Cover Ads $400 each in Color
_________ Total Purchased
Print, complete, and enclose registration form along with payment to:
Fuquay Varina Lions Club
P.O. Box 117
Fuquay-Varina, NC 27526
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