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Hole In “One”

Hospice Tournament

TO BENEFIT WV CARING HOSPICE

“Hole In One Hospice” Tournament Registration

Please complete all sections of this form to register for the “Hole In One Hospice” Tournament at Glenville Golf Club.

How many players will you be registering?

Registration Fee Per Player

Price:

Player 1 Details

Player 1 Name(Required)

First Last

Player 1 Phone(Required)

Player 1 Email(Required)

Player 1 Address(Required)

Street Address Address Line 2 City State ZIP Code

Player 2 Details

Name

First Last

Player 2 Phone(Required)

Player 2 Email(Required)

Player 2 Address(Required)

Street Address Address Line 2 City State ZIP Code

Player 3 Details

Player 3 Name(Required)

First Last

Player 3 Phone(Required)

Email(Required)

Player 3 Address(Required)

Street Address Address Line 2 City State ZIP Code

Player 4 Details

Player 4 Name(Required)

First Last

Player 4 Phone(Required)

Player 4 Email(Required)

Player 4 Address(Required)

Street Address Address Line 2 City State ZIP Code

Payment Details

Name(Required)

First Last

Phone(Required)

Email(Required)

This email address will receive the confirmation summary of this purchase.

Total

Payment Method(Required)

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code

63497

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