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 EmailThis field is for validation purposes and should be left unchanged. Δ{{#message}}{{{message}}}{{/message}}{{^message}}Your submission failed. The server responded with {{status_text}} (code {{status_code}}). Please contact the developer of this form processor to improve this message. Learn More{{/message}}{{#message}}{{{message}}}{{/message}}{{^message}}It appears your submission was successful. Even though the server responded OK, it is possible the submission was not processed. Please contact the developer of this form processor to improve this message. Learn More{{/message}}Submitting… 2026 Sponsors Contact Us P.O. Box 1953Keller, TX 76244 brandy@keller-services.com 817-851-3475
