Eastside Academy's Annual Golf Tournament

Questions marked by * are required.

Name: *

Company Name:

Phone: *

Number of golfers in your party: 1 at $250 2 at $500 3 at $750 4 at $1000

Mulligans please! Purchase up to 2 mulligans per player for the tournament: -1 for $252 for $503 for $754 for $1005 for $1256 for $1507 for $1758 for $200

I would like to sponsor this event: 1 Hole Sponsorship at $1,000

Credit Card Type: * -VisaMasterCardAmerican Express

Name on Card: *

Card Number: *

Expiration Date: *

Golfer/Guest #1 *

Address #1: *

City/State/Zip Code #1: *

Email #1: *

HCP or average golf score #1:

Golfer/Guest #2

Address #2:

City/State/Zip Code #2:

Email #2:

HCP or average golf score #2:

Golfer/Guest #3

Address #3:

City/State/Zip Code #3:

Email #3:

HCP or average golf score #3:

Golfer/Guest #4

Address #4:

City/State/Zip Code #4:

Email #4:

HCP or average golf score #4:

Registration Confirmation: * I authorize Eastside Academy to charge my credit card for the amount stated above.