National Sports Center for the Disabled - outdoor recreation opportunities for individuals with disabilities

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• Kansas City
Golf Classic

Date: Monday, June 12, 2006
Time: Shotgun Start at 8:00a.m.
Location: Adams Pointe Golf Course, Blue Springs, MO

Golfers of all abilities are welcome, and all proceeds benefit NSCD sports programming in the Kansas City area. The NSCD partners with the Kansas City Parks and Recreation Department and other community groups to provide therapeutic recreation services and sport opportunities for the youth in your area.

Your participation will help NSCD-Kansas City continue to provide experiences that build self-confidence, physical fitness and independence for individuals with disabilities.

AbilityCAMP Registration Form

AbilityCAMP:

* required

Participant First Name:

Participant Last Name:

Company Name:

Address:

City:

State:

Zip Code:

Business Phone:

Home Phone:

Fax:

Email Address:

Method of Payment:

Check (Make payable to NSCD-Kansas City)

Credit Card (Please call xxx-xxx-xxxx)

Please register and bill me by June 1st.

Check Appropriate:

Foursome - $300
Individual - $75

Front Nine Sponsor - $1000	Lunch Sponsor - $750
Back Nine Sponsor - $1000	Drive Range Sponsor - $750
Cart Sponsor - $750	Hole Sponsor - $500
Putting Sponsor - $750	Other

Your Foursome:

Name:	Phone:	HDCP/Avg. Score:
Name:	Phone:	HDCP/Avg. Score:
Name:	Phone:	HDCP/Avg. Score:
Name:	Phone:	HDCP/Avg. Score:

Photo Release

I grant permission for Participant's picture to be used in publicity or brochures related to this event.

Agree:

Yes
No *

Participant Name:

Date:

Sign here:

__________________________

Please print this page out and bring it to the classic with you.

P.O. Box 1290, Winter Park, Colorado 80482 USA phone: 970.726.1540 or 303.316.1540 Fax 970.726.4112
Denver Office: 1801 Bryant St, Ste 1500, Denver, CO 80204 ph: 303.293.5711 fx: 303.293.5448 Email: info@nscd.org

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