Genesis Pro-Am Challenge August 18, 2014 Pro Sign-Up Sheet ___ I am committing to participate in the Genesis Pro-Am Challenge on August 18, 2014. Course Preference: TPC ___ Crow Valley ___ (We will try our best to place you in a foursome at your Course of preference.) Rain Dates: September 15, 2014 for Crow. There is NOT a rain date set for TPC. ___ I'm giving the Foundation approval to communicate with me via email. ___ I am committing to participate, if necessary, on the rain date that corresponds to the Club of choice. ___ I will attend the Awards Reception at the end of the day. ___ I am committing to donating a round of golf for four at my club. (Please mail gift certificate with this form.) ___ I will make a donation of items to be given away as prizes during the Reception and Awards Ceremony. (Please bring items to the Club Pro Shop when checking in.) List of Items: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Name ______________________________________________________________________ Club _______________________________________________________________________ Club Address _________________________ City/St/Zip ______________________________ Email Address _______________________________________________________________ Phone Number_____________________________ Cell Phone ________________________ Please provide your social security number in order to receive the appearance fee of $200 ______________________________. A check will be mailed to you after the tournament. Home Address _______________________________________________________________ City __________________________ State ___________ Zip Code _____________________ Questions? Please call Deb at (563) 421-6861, fax to 563-421-6869 OR email [email protected] Thank you!