1st Annual "Take a Swing at Histio" Charity Golf Event

Registration/Sponsorship Form

Name

E-Mail

Golfer #1

Golfer #2

Golfer #3

Golfer #4

Sponsorship Level Gold Sponsor $1500.00 Silver $1000.00 Bronze $750.00 Hole Sponsor $200.00 Beverage Sponsor $400.00 Goodie Bag Sponsor $250.00 Long Drive Sponsor $250.00 Closest-to-pin Sponsor $250.00 Dinner Sponsor $300.00 No sponsor/ Golf only Sponsor Only/No Golf

Contact person

Contact Phone Number

Comments:

After submitting this form, please click on the payment link on the home page. This will allow me to have an accurate count of golfers while the payment form goes directly to the Histiocytosis Association of America.

Thank You for your support!