Golfer Registration

I would like to make reservations for:
Individual Twosome Threesome Foursome Individual $350 - Twosome $650 - Foursome $1300
Please Bill: Me for the Group    Individual Group Members
A separate registration form is provided for each golfer. If playing in a group, please be sure to list the names of each golfer separately. If golfer name is currently unknown, please write unknown in the name field.
Golfer #1 (my information) Name:*  Company:  Address:*  City:*  State:*  AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYOther Zip Code:*  Phone:*  Fax:  Email:*  Handicap:  Required for determining flight assignment.   Golfer #2 Name:  Company:  Address:  City:  State:  AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYOther Zip Code:  Phone:  Fax:  Email:  Handicap:  Required for determining flight assignment.   Golfer #3 Name:  Company:  Address:  City:  State:  AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYOther Zip Code:  Phone:  Fax:  Email:  Handicap:  Required for determining flight assignment.   Golfer #4 Name:  Company:  Address:  City:  State:  AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYOther Zip Code:    Phone:  Fax:  Email:  Handicap:  Required for determining flight assignment.
Total Amount in $*:	Example: 1300
Invoice me   Charge to my Credit card**
Credit Card Type:**	Visa MasterCard American Express Discover
Name as appears on credit card:**
Card Number:**
Expiration Date:**	Month   1 2 3 4 5 6 7 8 9 10 11 12      Year     2010 2011 2012 2013 2014 2015
*Required fields.   **Credit Card required fields.

Baptist Homes is committed to protecting your privacy, and takes the confidentiality of your information very seriously. We use the highest level of security technology when dealing with your credit card transactions. To guard against fraud, your information is securely encrypted so that it cannot be read over the internet, and is available only to our financial office for processing. At no time is this, or any other donor information, made available to any other party. Since under normal circumstances charitable contributions are non-refundable, Baptist Homes does not have a refund policy and there is no product to ship for your donation.