Golf Registration
On-Line Registration for the 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?

Kathleen Heyworth
Executive Director
217-525-6800
FAX 217-525-4043

email: kathleen@miniobeirne.org
Hole Sponsor: Yes, I would like to support the Crisis Nursery and its mission to prevent child abuse and neglect by being a hole sponsor ($200 donation) at the May 24th golf tournament.
   
Contact Name
Business Name
Address
City/State/Zip
Phone ( ) -
   
Sponsor Recognition:
-
a prominently displayed sign at the tee box
-
a prominent spot in the program book
-
one free entry into the golf outing
   
Yes:

Please register my foursome at the special discount rate of $85.00 per golfer.

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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