Chappell Golf Club; Chappell, NE

June 29, 2013
11 a.m. Registration
12 p.m. Shotgun start

Only $65 per golfer!
Includes a round of golf, cart, flag prizes, gift bag, lunch and a meal and awards ceremony that immediately follows play.

For more information, call Jason Gerdes toll free at 1-888-656-6254 or e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Sullivan Hills Camp Classic Golf Registration

Registration deadline: June 15, 2012. Please include payment with registration. Individual registrations will be grouped into foursomes.

Name (captain)

Congregation/Company

Address

City

State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Columbia (District of) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Home Phone

Work Phone

E-mail address

__________________________________________________________________

No. 2 Name

Congregation/Company

Address

City

State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Columbia (District of) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Home Phone

Work Phone

E-mail Address

__________________________________________________________________

No. 3 Name

Congregation/Company

Address

City

State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Columbia (District of) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Home Phone

Work Phone

E-mail Address

__________________________________________________________________

No. 4 Name

Congregation/Company

Address

City

State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Columbia (District of) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Home Phone

Work Phone

E-mail Address

When you hit the submit button, your registration information will be sent to the Registrar. You will then be transfered to PayPal to pay your registration fee ($65 per golfer). The registration will not be deemed valid until we have confirmation from PayPal that your payment has been received.

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