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