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GOLF REGISTRATION FORM

The Ryne Duren Celebrity Golf Tournament

supporting

 Winning Beyond Winning

Monday, June 23rd, 2008

 
(   )  Yes, I want to participate in the Ryne Duren Celebrity Golf Classic
        on Monday, June 23, 2008.   Here is my check for $________ to pay for ________
        golfer(s).  Following are the name(s) and addresses of the golfer(s)
        covered by this check.

(   )  I am unable to play in the golf outing, but would like to attend the dinner.
        Enclosed is my check for $_________.  (Seating is limited and will be
        accepted on a first come first served basis.)

(   )  Yes, I want to support the Celebrity Golf Classic, but can not attend.
        Enclosed is my donation for $__________.

(1)         Name_______________________________________________________________

             Address______________________________________   Phone_________________

             Company_____________________________________________________________

(2)         Name_______________________________________________________________

             Address______________________________________   Phone_________________

             Company_____________________________________________________________

(3)         Name________________________________________________________________

             Address______________________________________   Phone__________________

             Company_____________________________________________________________

(4)         Name_______________________________________________________________

             Address______________________________________   Phone_________________

             Company____________________________________________________________

Foursome                           $ 1,600.00 - includes tee sign
Single Golfer                      $    400.00   
Dinner (per person)           $   125.00   

Please make check payable to "Winning Beyond Winning" and mail a printed
copy of this form to 12 Second Avenue, Farmingdale New York 11735.

Or, you can visit our Golf Outing page for additional payment options.