
Sunday - June 9, 2019
Time: AM Flight: 7:30 am / PM Flight: 1:30 pm - shotgun start
Cost: $200 per person - includes golf, lunch & gift ($100 tax deductible)
Team Registration
Flight Preference AM or PM (based on availability)
Company Sponsoring team (if applicable)
Team Member 1: Name: ___________________ / email: ________________________
Team Member 2: Name: ___________________ / email: ________________________
Team Member 3: Name: ___________________/ email: ________________________
Team Member 4: Name: ___________________/ email: _________________________
Team Foursome Registration: $800
Individual Player Registration: $200
Sponsorship Opportunities (see the sponsorship page for details)
- Diamond Sponsorship: $1250
- Platinum Sponsorship: $1000
- Gold Sponsorship: $500
- Silver Sponsorship: $250
- Pewter Sponsorship: $100
Company Name: ___________________________________________________
Name: ___________________________________________________________
Address: _________________________________________________________
Phone: ___________________________________________________________
Email: ____________________________________________________________
Method of Payment (Make checks payable to Ford KTP Cares)
Check / Money Order
Visa / MasterCard / American Express
____________________________________ credit card number __________ exp date
_____________________________________ signature
Amount to be charged: ______________________________________
Print out and Mail Completed Registration to:
Ford KTP Cares - Golf Scramble
PO Box 895
Pewee Valley, KY 40056
If you have questions: Please contact Mary Jo Bagley at (502) 339-3680
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