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Please fill out the form below to register to for the 2nd annual Dr. Jay Hit and Run Golf Classic.

First Name:.
Last Name:.
Address:
Postal Code:
Home Phone #:
Bus. Phone #:
Cell Phone #:
Email:
Shirt Size:
Approx.Golf Level:

<80
80-90
90-100
>100

Approx. 5 km Time: <20 min
20-25 min
25-30 min
30-35 min
>35 min
Event: Individual (Lone Runner)
Team (Tandem)
Partner (if team):
*Both partners must register seperately
The money raised by this event will help fund pediatric palliative care.

NO ENTRY FEE

Terms and Conditions
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By checking this box you are committing yourself to raise a minimum of $1000 (Lone Runner event) or $1500 per team (Tandem event) for charity. Donation software will be provided to assist you in your fundraising efforts. Top fundraisers will be recognized. If you do not raise this amount by 1 month after the event, July 18, 2007, your credit card will be charged with the balance of your unmet minimum donation.

Please click here to read the waiver.

By checking this box, you are stating that you have read and agree to the terms and conditions, including the waiver.

Thank You! We can't wait to see you out on the course!
All registrants will receive an information package by e-mail.


     
 

© Copyright 2006 Hit and Run Golf