Full Name:    

Address:   

City:       State:            Zip:  

Phone:      Cell Phone:

Email Address:  

Please list other members in your foursome – if you do not have a foursome, we will pair you with other singles.

Golfer #2:

Golfer #3:

Golfer #4:
 

Options:

Individual Golfer - $125 payable online or by check

4 Player Team - $500 payable online or by check (please reference original registrar if separate payments are made)

I can't attend but I'd like to make a donation in the amount of $.

Tee Sponsor - $100 per sign with the following individual/business name: 
 

Please pay online or make checks payable to "Connecticut Storm" and mail to:

Connecticut Storm, P.O. Box 826, Norwich, CT 06360

Connecticut Storm is a non-profit tax-exempt organization, contributions may be tax deductible.