Golf Tournament Registration Form 2009
6th Annual Tee-off For Teens
Thursday, September 24, 2009
The Reserve Vineyards and Golf Club

10:30 a.m. Check-in / Lunch
12:00 p.m. Tee-off / Shotgun Start

Note: Each playing spot includes one round of golf with cart, box lunch, dinner,
$50 Nike Bucks and tee prize package.

A YMCA representative will be contacting you shortly to confirm your registration
and collect payment information. We accept Checks, American Express, Visa, MasterCard and Discover card.

Questions?
For more information regarding your team reservation and to make a payment, please call Justin Birmingham,
Program Executive Director of the YMCA Teen Division at 503.327.0016 or email at jbirmingham@ymca-portland.org.

* Required fields
Name *
E-mail Address *
Contact Number
I Prefer To Be Contacted Via *	Phone Email
Best Time To Reach Me *	Morning Afternoon Evening
Company / Organization
Mailing Address
City, State, Zipcode
I Would Like to Reserve *	A Foursome Tee Time @ $1,000 An Individual Tee Time @ $250 Event / Hole Sponsor @ $2,000 Event / Hole Sponsor @ $1,500 Event / Hole Sponsor @ $500
Additional Reservations	A Foursome Tee Time @ $1,000 An Individual Tee Time @ $250 Event / Hole Sponsor @ $2,000 Event / Hole Sponsor @ $1,500 Event / Hole Sponsor @ $500
Additional Reservations	A Foursome Tee Time @ $1,000 An Individual Tee Time @ $250 Event / Hole Sponsor @ $2,000 Event / Hole Sponsor @ $1,500 Event / Hole Sponsor @ $500
Participant #1: Name, Phone, Email, Handicap *
Participant #2: Name, Phone, Email, Handicap
Participant #3: Name, Phone, Email, Handicap
Participant #4: Name, Phone, Email, Handicap
I Need to Submit Additional Participant Names	Yes No

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