Southeast Charity Classic April 16, 2015

SOUTHEAST CHARITY CLASSIC APRIL 16, 2015

PARTICIPANT AGREEMENT

INDIVIDUAL PLAYER: $600.00 *Includes: Golf, Dinner Reception and Auction

Dinner Only: $100.00 RENTAL CLUBS, $75.00

Type of Sponsorship /

Cost

/ # Needed /

Type of Sponsorship

/

Cost

/ # Needed
·  Dinner
·  Lunch
·  Closest to the Pin
·  Longest Drive / $5,500
$5,500
$5,500
$5,500 / 10
10
2
2 / ·  Hole –in – One
·  Driving Range
·  Golf Cart
·  Holes / $5,500
$5,500
$3,500
$3,500 / 2
1
2
36

PARTICIPANT INFORMATION

PLEASE RESPOND NO LATER THAN MARCH 13, 2015

Company Name:
Phone: / Contact Person:
Email:
INDIVIDUAL AND/OR SPONSORSHIP PLAYERS / Phone # / CLUB RENTAL $75.00 per rental
1) / /
2) / /
3) / /
4) / /
1) / /
2) / /
3) / /
4) / /
DINNER ONLY / $100
1) / /
2) / /

TOTAL AMOUNT DUE INCLUDING CLUB RENTAL: $

Type of Participation/Sponsorship:

There are two forms of payment: Check or Credit Card (Visa, MasterCard or American Express)

CARD NUMBER EXPIRATION DATE TYPE (V, MC, AE)

NAME AS ON CARD PHONE NUMBER OF CARD HOLDER

Email Participant Agreement with Credit Card Payment to: mailto:

Make check payable to Costco Wholesale Charity Classic, Mail Check w/Agreement

SE Regional Office

3980 Venture Dr. Suite W-100, Duluth, GA 30096 Attn: Lisa Reinert.