Contact Name*

First Last

Email*

Phone*

Billing Address (Address where credit card statement is sent)*

Street Address City State ZIP Code

Payment Information

Golf Fee Per Player

Quantity of Golfer Fees

Raffle Tickets

Three $500 Cash Raffle Prizes. Drawing occurs Monday, June 5, and we will contact you if you win.

Hidden

Mulligans

I am unable to play in CLV’s Golf Tournament but would like to donate to the resident’s Benevolent Care Fund to help seniors at CLV. Please accept my tax-deductible gift.

Enter an amount in the box below.

Total

$0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

*A portion of registration fees are not tax deductible.

Golfers

Register the following golfers. Payment covers fees for all golfers.

Golfer 1: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

Golfer 2: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

Golfer 3: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

Golfer 4: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

GOLFER 5: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

GOLFER 6: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

GOLFER 7: First Name

First

Last Name

Last

Phone

Email

Age

Do you want to register another golfer?

Yes
No

GOLFER 8: First Name

First

Last Name

Last

Phone

Email

Age

Please call Monica Burnham at (443) 605-1068 or mburnham@clvillage.org to discuss any aspects of our Golf outing.

Your contact information will not be sold or shared with third-party vendors.

Carroll Lutheran Village is extremely grateful to the individuals and organizations that help support us in our mission of caring for each resident, regardless of their financial limitations. Join us Friday, June 7 at The Links at Gettysburg.

Golf Player Form

Payment Information

Golfers

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Floor Plans

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