Rotary International

Bellevue Breakfast Rotary Club

 

2011 ONLINE REGISTRATION

Willow’s Run Golf Course, Monday, July 25, 7:45 AM Shotgun Start

If you can’t play golf but would like to support the BBRC fundraising efforts with an individual sponsor donation, please click the donation button at right and skip the rest of the form. Your online donation and information will be processed through PayPal's secure servers.

Check all boxes that are applicable.  In the HDCP box, please provide a GHIN Index or an estimated 18-hole score.

* indicates a required field

First Name *

Last Name *

Team Captain**

Rotarian

Free Player***

HDCP *

Address *

City* St* Zip*

Email Address *

Repeat Email *

Home Phone *

Cell Phone

OTHER PLAYER(S) IN YOUR GROUP

If you are a Team Captain, please enter name(s), email address(es) and handicap(s) of other player(s) in your group. Enter TBD for player names yet to be determined. Then enter the total players in your group in the box at the bottom.

If you are paying for yourself only, please remind your playing partners that they must submit their own payments and registration forms.

** Team Captain accepts responsibility for ensuring all Team Players complete payment and registration information.

Player 2 Name

HDCP

Email Address

Pymt by Team Cap     Free Player***

Player 3 Name

HDCP

Email Address

Pymt by Team Cap     Free Player***

Player 4 Name

HDCP

Email Address

Pymt by Team Cap    Free Player***

# players in your group (include TBD players) *

Once your payment has been received, your registration is confirmed.

PAYMENT INFORMATION

# of players @ $180 each for whom you are registering & submitting payment *

*** NOTE TO SPONSORS: Your paid sponsorship entitles you to a number of free golfers (see below).

SPONSORSHIP PAYMENT (if applicable & not previously paid)

Eagle = $2,500 (entitled to 4 free golfers)

Birdie = $1,250 (entitled to 2 free golfers)

General = $625 (entitled to 1 free golfer)

TOTAL PAYMENT *

$

PAYMENT METHOD

Check (make payable to “BBRC”) *

Visa, Mastercard, Amex, Discover *

Visa, MC, Amex & Discover-payments processed by PayPal

ADDITIONAL INSTRUCTIONS/PREFERENCES

AFTER YOU SUBMIT THIS FORM

You will be redirected to a confirmation page with a link for online payment with your credit card (Visa, MC, Amex, Discover). Click the payment link and enter the total amount of your payment and then your credit card information.

All payments are processed through PayPal's secure servers. You do not need to have a PayPal account to pay online with your credit card. CLICK HERE FOR A PAYPAL INSTRUCTION SCREENSHOT.

After you complete your transaction, you will receive an email from PayPal confirming your payment.

You will also receive an email from the Golf Committee with the information you submitted on this form. If you do not receive one or both of these emails, please contact Howard Johnson at hojuj@comcast.net.

IF YOU ELECTED TO PAY BY CHECK:

Mail your check to:

BBRC Golf / Howard Johnson
150 102nd Ave SE, #206
Bellevue, WA 98004
Email: hojuj@comcast.net

Make checks payable to "BBRC"

Delete the text in the field below *

The field above must be blank. This is a spam protection measure.