Meet Our Sponsors Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Enter Email Confirm Email How Are You Participating In This Years Golf Outing?*$10,000: Course Sponsor - Includes 2 Foursomes - guaranteed Wissahickon course if requested (see sponsorship packet for additional benefits).$5,000 Flag Sponsor: - Includes 2 Foursomes (see sponsorship packet for additional benefits).$3,000 Cup Sponsor: Includes a Foursome - (see sponsorship packet for additional benefits).$1,000 Green Sponsor: See sponsorship packet for additional benefits).$500 Pro Sponsor: Corporate logo displayed on signage at the pro shop Includes keepsake pin flag with name or logo of your choice. You will also be given the opportunity to sign up to play golf by choosing this option.$250 Tee Sponsor: Corporate logo displayed on signage at the event. Includes keepsake pin flag with name or logo of your choice. You will also be given the opportunity to sign up to play golf by choosing this option.IndividualMultiple/Foursome GolfersWould you like to register for golf?YesNo$10,000 Course SponsorCourse Sponsor Price: $10,000.00 $5,000 Flag SponsorFlag Sponsor Price: $5,000.00 $3,000 Cup Sponsor$3,000 Cup Sponsor Price: $3,000.00 $1,000 Green Sponsor$1,000 Green Sponsor Price: $1,000.00 $500 Pro Sponsor$500 Pro Sponsor Price: $500.00 $250 Tee Sponsor$250 Tee Sponsor Price: $250.00 Individual Golfer Sign UpIndividual Golfer Price* Price: $500.00 For this individual golfer, use the contact information above?*YesNoIndividual Golfer Name* First Last Individual Golfer Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Individual Golfer Email* Enter Email Confirm Email Individual Golfer Phone*Name of Foursome*Individual/Multiple/Foursome Golfer Sign UpNumber Of Golfers*Please enter a number from 1 to 8.Golfer Price*$500 per golfer Price: $1,400.00 For golfer one, use the contact information above?*YesNoGolfer One Name*Main contact for the group. First Last Golfer One Address*Main contact for the group. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Golfer One Email*Main contact for the group. Enter Email Confirm Email Golfer One Phone*Main contact for the group. Name of Foursome*Golfer Two Name* First Last Golfer Two Email* Enter Email Confirm Email Golfer Three Name* First Last Golfer Three Email* Enter Email Confirm Email Golfer Four Name* First Last Golfer Four Email* Enter Email Confirm Email Name of Foursome*Golfer Five Name* First Last Golfer Five Email* Enter Email Confirm Email Golfer Six Name* First Last Golfer Six Email* Enter Email Confirm Email Golfer Seven Name* First Last Golfer Seven Email* Enter Email Confirm Email Golfer Eight Name* First Last Golfer Eight Email* Enter Email Confirm Email Sponsorship Foursome #1Please fill out every golfer playing in your group. The first golfer listed will be the main contact for the group.Name of Foursome*For golfer one, use the contact information above?*YesNoGolfer One Name*Main contact for the foursome. First Last Golfer One Address*Main contact for the foursome. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Golfer One Email*Main contact for the foursome. Enter Email Confirm Email Golfer One Phone*Main contact for the foursome. Golfer Two Name* First Last Golfer Two Email* Enter Email Confirm Email Golfer Two Phone*Golfer Three Name* First Last Golfer Three Email* Enter Email Confirm Email Golfer Three Phone*Golfer Four Name* First Last Golfer Four Email* Enter Email Confirm Email Golfer Four Phone*Sponsorship Foursome #2Please fill out every golfer playing in your group. The first golfer listed will be the main contact for the group.Name of Foursome*Golfer Five Name* First Last Golfer Five Email* Enter Email Confirm Email Golfer Five Phone*Golfer Six Name* First Last Golfer Six Email* Enter Email Confirm Email Golfer Six Phone*Golfer Seven Name* First Last Golfer Seven Email* Enter Email Confirm Email Golfer Seven Phone*Golfer Eight Name* First Last Golfer Eight Email* Enter Email Confirm Email Golfer Eight Phone*Tee Time/Course InfoChoose Your Course*Wissahickon course (walking only) & 2 caddies per foursome. Militia Hill carts included. Militia Hill CourseWissahickon CourseTee Times*Choose your desired tee time range. We will do our very best to accommodate your request. Colleen Knoble will be in touch to secure your tee time. **Please be prepared to arrive 1 hour before your tee time to enjoy brunch/lunch, and to stay an hour after your round to enjoy lunch/dinner.Morning - 7:30am - 10amMid-day - 10am - 1pmAfternoon - 1pm - 3:30pmSponsorship Name And Logo UploadName(s) to appear on sponsorship signage:*Logo(s)128MB maximum file size. If you don't have a logo handy, just email it to us before February 8th. Drop files here or Any additional commentsDonationWould you like to make a donation to the Breathing Room?*Of course!Not todayPrice* PaymentWould you like to help The Breathing Room cover the processing fees? I'd like to help cover the transaction fees on my donation. Add Price: $0.00 Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Total $0.00 Δ
