Golfer Registration Form
Golfer Registration Form Please mail this registration form to: Edgewood Management Group OR bring it with you to King's Walk on the day of the tournament
Attn: Jenni Hoffmann 322 Demers Avenue, Ste. 401 P.O. Box 13238 Grand Forks, ND 58201
Golfer Information First Name:_______________________________ Last Name: __________________________________ Address:________________________________________________________________________________ City: ___________________________________________ State: ______________ Zip:______________ Phone number: _____________________ Email Address: _____________________________________
Donation Information I would like to pay: $125 (Single Golfer) x ______ golfers = $___________ (Total) ______$500 (Team of 4 Golfers) I would like to make an additional donation to the Alzheimer's Association in the amount of:
___ $100 ___ $75 ___ $50 ___ $25 ___ $10 ___ Other (please specify an amount) ________________ I would like to include a tribute message with my donation (please mark your sentiment and fill in a name):
___ In Honor of ___ In Memory of ___ In Support of ______________________________________
_____Enclosed is my check payable to the Edgewood Management Group LLC Please charge my: ______Visa
_______MasterCard
_______American Express _______Discover
Credit card number: ____________________________________ Expiration date: _________________ Signature: __________________________________________ Today’s date: _______________________
If you or someone you know needs information, referrals or support regarding Alzheimerʼs disease please call the Alzheimerʼs Association 24/7 Nationwide Helpline at 800.272.3900 or visit alz.org.
Attn: Jenni Hoffmann 322 Demers Avenue, Ste. 401 P.O. Box 13238 Grand Forks, ND 58201
Golfer Information First Name:_______________________________ Last Name: __________________________________ Address:________________________________________________________________________________ City: ___________________________________________ State: ______________ Zip:______________ Phone number: _____________________ Email Address: _____________________________________
Donation Information I would like to pay: $125 (Single Golfer) x ______ golfers = $___________ (Total) ______$500 (Team of 4 Golfers) I would like to make an additional donation to the Alzheimer's Association in the amount of:
___ $100 ___ $75 ___ $50 ___ $25 ___ $10 ___ Other (please specify an amount) ________________ I would like to include a tribute message with my donation (please mark your sentiment and fill in a name):
___ In Honor of ___ In Memory of ___ In Support of ______________________________________
_____Enclosed is my check payable to the Edgewood Management Group LLC Please charge my: ______Visa
_______MasterCard
_______American Express _______Discover
Credit card number: ____________________________________ Expiration date: _________________ Signature: __________________________________________ Today’s date: _______________________
If you or someone you know needs information, referrals or support regarding Alzheimerʼs disease please call the Alzheimerʼs Association 24/7 Nationwide Helpline at 800.272.3900 or visit alz.org.
