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Golf Registration
Register For:
Golf & Dinner
Golf Only
Dinner Only
Ball Drop Only
*
First Name:
*
Last Name:
*
Company:
Address:
*
City:
*
State/Zip:
/
*
Phone:
*
Email:
*
Reserve Player(s):
Select
1
2
3
4
Golfers @ $200/player, $700/foursome
Group:
Sponsor:
Name as it will appear on signage.
Golfer's Name
*
Email
Day Phone #
Shirt Size
Select
X-Small
Small
Medium
Large
X-Large
XX-Large
Select
X-Small
Small
Medium
Large
X-Large
XX-Large
Select
X-Small
Small
Medium
Large
X-Large
XX-Large
Select
X-Small
Small
Medium
Large
X-Large
XX-Large
*
Required
Dinner Reservation Only
# Reserve:
Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
@ $35/per person
Reserved For:
(Name on reservation)
Ball Drop
Each Ball:
Qty
(x $10)
Set of 3 Balls:
Qty
(x $25)
Payment Options
Address same as above.
First Name:
*
(as it appears on card)
Last Name:
*
(as it appears on card)
Billing Address:
*
Billing City:
*
Billing State/Zip:
/
*
Phone:
*
Check Pay By Mail
Payable to: Pulmonary Hypertension Association
(A non-profit 501 (c)(3) foundation. Tax ID # 65-0880021)
*Please note "Wojo PH Golf Classic" on the memo line
Credit Card:
Please Select
Visa
Master Card
American Express
Discover
Credit Card No.:
*
Expiration Date:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Year
2012
2013
2014
2015
2016
2017
2018
2019
*
CCV#:
*
(3 or 4 digit number)
How Did You Hear About Us?
Mail Registration to:
Swing4theCure
c/o BettyLou Wojciechowski
24232 Chrisanta Dr.
Mission Viejo, CA 92691
Email Tournament Contact:
BettyLou@swing4thecure.us
Phone: (949) 230-9955
Swing4TheCure.us
24232 Chrisanta Dr.
Mission Viejo, CA 92691
(949) 230-9955
info@Swing4TheCure.us
