Tournament Registration Tournament Registration Form Contact Name* First Last Title Company Name Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact NumberEmail* SPONSORSHIP/PLAYER LEVELSPlease select:*- Please select -Hole-In-One Sponsor - $5,000Birdie Sponsor - $3,000Par Sponsor - $1,500Bottle Bonanza - $1,000Bunker Sponsor - $750Hole Sponsor (non-playing sponsorship) - $250PLAYING SPOTS/SUPER TICKETPlease select:- Please select -Player Registration* - $175Foursome Registration* - $650Player Registration with Super Ticket - $250Foursome Registration with Super Ticket - $950Super Ticket - $100 (after 4/24- $125)Foursome Super Ticket - $400 (after 4/24- $500)All sponsorship levels, individual players and foursomes include: *Round of golf *Lunch *Goody bag *Golfer gift *Closest-to-the-Pin and Longest Drive Contest *Dinner/AwardsPLAYER INFORMATIONListNameEmail PAYMENT DETAILSTotal $0.00 Payment Method*- Please select -Send Invoice (due April 4, 2026)Check EnclosedCredit Card via PayPalPayment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro Card Number Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged. Δ 2026 Sponsors Contact Us P.O. Box 1953Keller, TX 76244 brandy@keller-services.com 817-851-3475
