ALS Shootout Register

* Indicates required field

Let's Play Golf!

Name *

First

Last

REGISTRATION TYPE: *

Individual ($100) - Indicate any preferred teammates in comments Team ($400-500) - Include name & email of other team members below

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Comment *

In order to keep game play moving, at least one cart is required per team. *

Reserve one cart ($30) Reserve two carts ($60) Reserve three carts ($90)

Payment Method *

I will be paying now. Look for my check in the mail.

Name *

First

Last

Email *

Name *

First

Last

Email *

Name *

First

Last

Email *

Name *

First

Last

Email *

Submit Registration