Team or Team and Sponsor Form

2023 Golf Scramble Sponsorship and Registration Form

Monday, July 10 | Scotts Bluff Country Club

Please complete this form and payment by June 13, 2023

Please note: Scotts Bluff Country Club dress code requires men to have a collared shirt and no denim. Ladies, no tank tops, halter tops, or short-shorts. Hard spikes will not be allowed on the course.

Current Method of Payment
Complete

Company or Team Name

Preferred tee time - Early registration qualifies team for choice of tee time.

8 a.m. shotgun start (7 to 8 a.m. registration)

1 p.m. shotgun start (noon to 1 p.m. registration)

Type of Sponsorship (One mulligan package included with any team sponsorship)

$1,200 team and tee box sponsor

$1,050 team and event sponsor

$650 team sponsor

Extra mulligan packages

Number of Extra Mulligan Packages at $68 each

Total Cost of Mulligans ($68 each)

Total Amount Due (Registration plus cost of mulligans)

Player Information

Player 1 First Name

Player 1 Last Name

Address

City

State

Zip Code

Phone Number (Insert Numbers Only)

Average Score or USGA Handicap

Player 2 First Name

Player 2 Last Name

Address

City

State

Zip Code

Phone Number (Insert Numbers Only)

Average Score or USGA Handicap

Player 3 First Name

Player 3 Last Name

Address

City

State

Zip Code

Phone Number (Insert Numbers Only)

Average Score or USGA Handicap

Player 4 First Name

Player 4 Last Name

Address

City

State

Zip Code

Phone Number (Insert Numbers Only)

Average Score or USGA Handicap

Preferred Method of Payment

PayPal or credit card (you will be taken to the PayPal page after you click submit)

Check (Please contact the Foundation at 308-630-1485, or at alica.palu@rwhs.org after clicking the submit button)

Primary Care

Urgent, Emergent, and Trauma Care

Specialty Care

2023 Golf Scramble Sponsorship and Registration Form

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