Register

First Name *

Last Name *

Organization

Address *

Zip *

Phone *

Email *

Sponsorship/Tickets *

Presenting Sponsor - $4,000

Gold - $2,000

Silver - $1,000

Bronze - $500

Practice Green Sponsor - $750

Practice Tee Sponsor - $750

Tee Sponsor - $150

Foursome - $600

Single - $150

Dinner - (Adult) - $50

Dinner - Child - $30

Golfer 1 *

Golfer 2 *

Golfer 3 *

Golfer 4 *

Number of adults *

Number of children *

Number of Tee Signs *

Coupon

Total Amount

$

Discount Amount

$

Gross Amount

$

Payment method *

Paypal
Pay By Check

Billing Zipcode*

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*

West Hartford Youth Hockey Association