2010 Golf Registration Information

Firestone Country Club
North Course
Saturday, April 24, 2010
11:30 a.m. Lunch; 1:00 p.m. Tee-Off
Awards Dinner Follows

2010 Golf Registration

Come see Professional Long Ball Champion Mike Ziegler!

Please complete the form below to register as a foursome or individually to golf in the event. Once you complete the form you will have the opportunity to make your payment by filling out a secure online payment form.

Outing Cost: $250 per golfer or $1,000 per foursome. A minimum of $100 per golfer must be paid prior to the day of the event. Registrations received after March 31 cannot be guaranteed placement.

Thank you for your support of Lake Center Christian School!

Name:

Company Name (If Applicable):

Email:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Home Phone Number:

Business Phone Number:

I will pay online:

Yes

No

Please have LCCS invoice me:

Yes

No

Golfer #1 Name: Handicap/Ave. Score #1:

Golfer #2 Name: Handicap/Ave. Score #2:

Golfer #3 Name: Handicap/Ave. Score #3:

Golfer #4 Name: Handicap/Ave. Score #4:

**Note**
If the golfers name is not known at this time
just leave the box blank and we will contact
you via email closer to the event to update the information.

Please select the amount you would like charged to your credit or debit card:

$250
$500
$750
$1,000

To submit your information and go to a secure online payment form, please click below.

Thank you for participating in the 2010 Howard R. Miller Memorial Golf Outing!