Mid CT Classic

Reservation Form
(please print and complete this form)

Choose your format:
____Scramble
____ Play your own ball w/ best ball scoring. (Requirements: Must pre-register with a foursome with each player having a handicap of no more than 20.)

Name: ____________________________________
Company: _________________________________
Address: __________________________________
__________________________________________
Phone:______________________handicap______

Name: ____________________________________
Company: _________________________________
Address: __________________________________
__________________________________________
Phone:______________________handicap______

Name: ____________________________________
Company: _________________________________
Address: __________________________________
__________________________________________
Phone:______________________handicap______

Name: ____________________________________
Company: _________________________________
Address: __________________________________
__________________________________________
Phone:______________________handicap______

I will not be able to attend, but please accept my donation of $________.

Registration fee per golfer
 Paid Registration by April 15th- $175.00
Paid after April 15th - $190.00

Sponsorship
Click here for more information

Pre-purchase Raffle Tickets
$20 per set of 15

# of Golfers_____ x $______ = Golf Total______
Sponsorship ______
Raffle Total______
TOTAL ENCLOSED_____


Method of Payment (Please check one)

Check (Check #________)
MasterCard____    Visa____   Discover ____

Card #__________________________exp_____

Signature________________________________

Printed Name_____________________________

Address__________________________________

_____________________________zip_________

Phone___________________________________

Please make checks payable to:
American Red Cross
Middlesex Central CT Chapter

Mail this form to:
97 Broad Street
Middletown, CT 06457

Or Fax to: (860) 346-1869

For more information, send an email to golf@midctredcross.org

Thank you for your support!