Please complete the registration form below.
First Name (required)
Last Name (required)
Email (required)
Zip Code
Are you a Veteran? YesNo
Role (Select All That Apply) Adaptive GolferAble-Bodied GolferFirst-TimeVolunteer
What adaptive equipment do you need (if any) NONESolo RiderParamobile Right-HandedParamobile Left-HandedCaddy (assistant)
Will you be staying for lunch? (Sponsored by Gateway Mortgage) YesNo
Lunch Selection (select one) (All three options will be served with Chips) CheeseburgerHot DogChicken SandwichMushroom Burger (vegetarian option)
Will you be playing golf afterwards? YesNo
Select month you will attend. December
READ THE PHOTO RELEASE TERMS AND LIABILITY WAIVER FORMS. You will not be able to finish registration without agreeing to the photo release and liability terms.
I agree to the Photo Release terms.
I agree to the Liability Waiver terms.
Δ