Golf Outing – I Have Wings

Please mail form and check to: P.O. Box 18502 Erlanger, KY 41018
Pay by check & mail here
Golf Registration
REGISTRATION TYPE
Number of Golfer(s) (Tax Included)*
Number of Golfer(s) (Tax Included)*
Number of Golfer(s) (Tax Included)*
Number of Holes*
Golfer Information
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Golfer's Name*
First Last
Sponsorships
Sponsorships
Raffle Ticket Purchase
Please Choose Your Raffle Ticket
How Many Tickets Would You Like?*
Contact Information
Name*
First Last
Email*
Phone*
Billing Information
Billing Address*
Street Address Address Line 2 City State ZIP Code
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00

$5	Provides one round trip bus fair to and from chemotherapy, or pays for 1 care package to arrive at breast cancer patients door during treatment.
$10	buys a child a new toy at Christmas while mom is going through cancer treatments, provides 20 women with an inspirational card during treatment.

$15	a pick me up fruit basket for a family of 4 during chemotherapy.
$25	Purchases gasoline for survivor to drive to Dr. appointments for radiation or chemo or flowers for a woman recovering from surgery in the hospital after a mastectomy.
$50	Puts Thanksgiving or Christmas dinner on the table for a family going through a breast cancer diagnosis, or pays for a prosthetic bra.
$60	pays for a compression sleeve for a woman suffering with lymphodemia
$100	pays a chemo patients water & sanitation bill for 3 months, or sponsors a family at Christmas.
$150	pays a chemo patients winter heat bill for a month.
$250	pays for prosthetic breast for a woman after surgery or wig for woman who just lost her hair from chemo.

Golf Registration