Golf Classic Registration Form

To register for the Golf Classic, please complete the form below.

Please Register by Wednesday, May 28th.

Golfer First Name:
Golfer Last Name:
Address:
Address (cont):
City:
State:
Zip:
Phone: (with Area Code)
Email:
Company:
Foursome Coordinator:
Golfing in honor of:
Sponsor/Golfer Choice:
Registration Type:
$175 Individual Golfer $325 Two Golfers $500 Three Golfers $600 Foursome

	I will form a Foursome
	I am part of a Foursome
	I want to join a Foursome

$	I wish to make a donation to DSA, Down Syndrome Alabama for amount specified

Total:	$
Credit card type:
Credit card number:
Credit Card Expiration Date:
Exact name on card:

Golf Classic Participants by clicking on "I Agree," you agree, warrant and covenant as follows: Waiver: In consideration of me and/or my minor child being permitted to participate in the Golf Classic, I hereby-for myself, my heirs and personal representatives assume any and all risks which might be associated with the event. I further waive, release, discharge and covenant not to sue Down Syndrome Alabama and Inverness Country Club, their sponsors, organizers, volunteers or other representatives or their successors and assigns, for any and all injuries or damages of any kind whatsoever suffered by myself and/or my minor child as a result of taking part in the events and any related activities. I also authorize the use by Down Syndrome Alabama of any photo, film or videotape taken of me or my minor child at the event for any purpose.

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