2019 Charity Golf Classic Registration
May 31th, 2019 Great Life Golf and Fitness 4 Person Scramble

* indicates required fields 
  *Team Name:
  *Player 1 Name:
  Player 1 Address:
  Player 1 Phone Number:
  Player 1 Email:
  *Player 2 Name:
  Player 2 Address:
  Player 2 Phone Number:
  Player 2 Email:
  *Player 3 Name:
  Player 3 Address:
  Player 3 Phone Number:
  Player 3 Email:
  *Player 4 Name:
  Player 4 Address:
  Player 4 Phone Number:
  Player 4 Email:
  *Payment Method:
  *Payment Designated for the Following Team Members:

Please note the following payment options. Payments may be made online via PayPal or in office, 203 S Santa Fe, by Check payable to DVACK. Payments may be made for individual team members* ($75 per person) or paid in full ($300 for 4 Person Team). * When making payment for individual members, please indicate in the Payment Designation field of the registration page those members in which the payment is to be applied. After filling the details click on the SUBMIT button.

PO Box 1854  |  Salina, KS 67402-1854  |  (785) 827-5862 or (800) 874-1499  |  fax: (785) 827-2410

     Services of DVACK are free and confidential


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