Golf Registration
On-Line Registration for the 2017 Mini O'Beirne Golf Tournament.
 
Requestor:
Name
Address 1
Address 2
City
St
Zip
Phone ( ) -
Fax ( ) -
E-Mail
Please remit payment to:
Mini O'Beirne Crisis Nursery
1011 North Seventh Street
Springfield, Illinois 62702
 
Questions?

Karen L. Cox, LCSW
Executive Director
217-525-6800
FAX 217-525-4043

email: karen@miniobeirne.org

Yes, I would like to support the Crisis Nursery and its mission to prevent child abuse and neglect by being a sponsor (Select type of sponsor below) at the May 25th, 2017 tournament.
Title Sponsor - $1,000
Includes 4 playing spots, 4 dinners, prominent sinage, ad on website and acknowledgement prior to play and at dinner
Dinner Sponsor - $750
Includes 4 dinners, prominent sinage at dinner, and acknowledgement at dinner
Beverage Cart - $500
Includes signs on beverage cart, 2 playing spots, 2 dinners, and announcement prior to start
Gold Bear - $500
Includes 4 playing spots, 4 dinners, and tee sign
Silver Bear - $300
Includes 2 playing spots, 2 dinners, and tee sign
Blue Bear - $250
Includes 1 playing spot, 1 dinner, and tee sign
Special Hole Sponsor - $125
Hole Sponsor - $100
 
Contact Name
Business Name
Address
City/State/Zip
Phone ( ) -
   
I would like to only attend the dinner. $15.00
Yes:

Please register my foursome at the special discount rate of $360.00.

For single golfers, please enter golfers names starting in "Player 1" below. Please remit $100.00 per golfer.

Player 1
Name
Address
City/State/Zip
Phone ( ) -
Player 2
Name
Address
City/State/Zip
Phone ( ) -
Player 3
Name
Address
City/State/Zip
Phone ( ) -
Player 4
Name
Address
City/State/Zip
Phone ( ) -
Comment/Request

 
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