Contact Name
*
First Name
Last Name
Company Name
*
E-mail
*
example@example.com
Contact Number
*
Format: (000) 000-0000.
Payment Method
*
Credit Card (4% convenience fee applies)
Send Check
Are you sponsoring at this event?
*
Yes
No
Sponsorship Opportunities:
*
Event Sponsor $500: Buy 3, get 1 FREE golf & dinner registration
Dinner Sponsor $350
Lunch Sponsor $250
Beverage Cart Sponsor $250
Green or Tee Sponsor $185
Lowest Scoring Team Prize Sponsor $200
Longest Drive Prize Sponsor $100
Closest to the Pin Prize Sponsor $100
Longest Putt Prize Sponsor $100
Logo for signage
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Are you registering for golf and/or the trap shoot?
*
Yes
No
Are you bringing a "Gopher It" invite?
Yes
No
"Gopher It" Registration
Name
Phone
Email
"Gopher It" Registration
Please Select
Golf Only (free)
Golf & Dinner (free)
Trap, Golf, & Dinner (free)
Trap Only (free)
Dinner Only (free)
Registrant 1
*
Please Select
Golf Only $55
Golf & Dinner $80
Trap, Golf, & Dinner $110
Trap Only $35
Dinner Only $40
Registrant 2
*
Please Select
Golf Only $55
Golf & Dinner $80
Trap, Golf, & Dinner $110
Trap Only $35
Dinner Only $40
Registrant 3
*
Please Select
Golf Only $55
Golf & Dinner $80
Trap, Golf, & Dinner $110
Trap Only $35
Dinner Only $40
Registrant 4
*
Please Select
Golf Only $55
Golf & Dinner $80
Trap, Golf, & Dinner $110
Trap Only $35
Dinner Only $40
My preferred foursome Is
Leave blank if you do not have a preference
Registration total (used for discount purpose only)
Please mail a check for the total amount to Illinois LICA, 112 Exchange St., Suite 2, Galva, IL 61434
Calculation
Total
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( X )
USD
Includes 4% convenience fee
Credit Card
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