Keep Pushin To End Brain Cancer

Player Registration Form

Fill out the form below to register online.

PAYMENT INFO

Please make checks payable to “Keep Pushin Golf Tournament”, and mail to:
Lillian Desautels, 26 Trottingham Rd, Saratoga Springs ,NY 12866.

Player #1 Name:(Required)

Player #1 Address:(Required)

Street Address City State / Province / Region ZIP / Postal Code

Player #1 Phone:(Required)

Player #1 Email:(Required)

Player #1 Registration (select a registration option):

I am registering for the tournament ($185)

I am registering for dinner only ($70)

Player #2 Name:

Player #2 Address:

Street Address City State / Province / Region ZIP / Postal Code

Player #2 Phone:

Player #2 Email:

Player #2 Registration (select a registration option):

I am registering for the tournament ($185)

I am registering for dinner only ($70)

Player #3 Name:

Player #3 Address:

Street Address City State / Province / Region ZIP / Postal Code

Player #3 Phone:

Player #3 Email:

Player #3 Registration (select a registration option):

I am registering for the tournament ($185)

I am registering for dinner only ($70)

Player #4 Name:

Player #4 Address:

Street Address City State / Province / Region ZIP / Postal Code

Player #4 Phone:

Player #4 Email:

Player #4 Registration (select a registration option):

I am registering for the tournament ($185)

I am registering for dinner only ($70)