BBBS 2017 Putt-A-Round Registration Form

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SIGN UP BY JANUARY 4TH FOR THE

12th Annual Big Brothers Big Sisters

Putt-A-Round January 18—20 Great River Hall RiverCenter, Davenport www.bbbsmv.org/putt

st e g r a L r o o d in golf mini- in the e courisdwest! M Presented by:

Play 25+ uniquely designed mini-golf holes built by area businesses.

Cash bar and FREE food at every shift provided by over 15 area restaurants and pubs!

Contests, raffle prizes, 50/50 drawings, music, “Money Machine” and Plinko game!

Have a fun time with co-workers, family, groups or friends!

All proceeds benefitting mentoring through:

See early registration incentive on back side!


Register your Putt-A-Round Team by January 4th and be entered into a drawing for a Lexus Milwaukee get-away!

Early, paid registration by Jan. 4th, sponsored by: Use of a Lexus for the weekend, free tank of gas, 2-night stay at Heart of America Holiday Inn, dinner at Thunder Bay Grille and 2 TicketMaster gift cards!

2017 Putt-A-Round Registration Form (Jan. 18-20) Team Captain/Coordinator: _________________________Company/Group: ________________________ Address: ___________________________________City: ____________________ State: ___ Zip: _______ Phone: (______) _____________

□ Cell □ Home

Email: ________________________________________

Registration cost: $100 per team of 4 or $25 per person (all shifts include food) Total number of 4-person teams: ______ X $100/team = Individual registration: ______ X $25/person =

$ _______ $ _______

□ YES, I/my team played in Putt-A-Round 2016, last January. I heard about Putt-A-Round from: _________________________________________

PLEASE CHECK THE SHIFT YOU WILL BE ATTENDING: Wednesday, January 18:

Friday, January 20:

□ 11:30 a.m.—1:30 p.m. LUNCH AND PUTT: Enjoy a fun

□ 11:30 a.m.—1:30 p.m. LUNCH AND PUTT:

lunch-time experience! FREE lunch! 5:30—7:30 p.m. AFTER HOURS: Great way to enjoy “Happy Hour”!

Thursday, January 19:

□ 3—5 p.m. HOT SPOT: Wrap up your day the right way. □ 5:30—7:30 p.m. AFTER HOURS: Great way to enjoy “Happy Hour”! Value Pack Raffle Tickets will be available for purchase onsite with cash, debit card or check only. 50/50 drawing, Plinko game, plus 5 raffle tickets!

You must register and pay for your team by Jan. 4th to be eligible for the drawing; otherwise, the form and payment are due by Fri., Jan. 13 to: BBBSMV Attn: Kayla Kiesey 130 W. 5th St., Davenport, IA 52801 FAX: 563-333-2494 PH: 563-323-8006 Email: kkiesey@bbbs-mv.org

www.bbbsmv.com/putt

Enjoy a fun

lunch-time experience! FREE lunch!

□ 3—5 p.m. HOT SPOT: Wrap up your day the right way! □ 5:30—7:30 p.m. AFTER HOURS: Great way to enjoy “Happy Hour”! Payment Options: ____ Check enclosed ____ Invoice me

TOT. ALL CHARGES: $ ________ (Checks payable to Big Brothers Big Sisters; no refunds for no-show pre-registrations) ___ Credit Card: ___ Visa ___ Discover ___ Master Card (AMEX not accepted) Authorization Signature: ______________________________________________________ Date: _________________ Card # ________________________________________________ Exp. Date: ______________ Verification Code (3-DIGIT)____________


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