The Kristin Rita Strouse Foundation for the Prevention of Teen Suicide

The 10th Anniversary “Yellow Dress” Celebration of Life
Hayfields Country Club June 11, 2012

Sponsorship Registration Form

Golf Sponsorship Levels
$ AMOUNT	QTY.	SPONSOR LEVEL
$10,000	x ____	Gold Sponsors
$5,000	x ____	Silver Sponsors
$3,000	x ____	Corporate Sponsors
150.00	x ____	Individual Monday Dinner Ticket
$750.00	x ____	Hole Sponsor
Golf Packages
$750.00	x ____	Single Golfer
$1,400	x ____	Twosome
$2,000	x ____	Foursome
Total	= _____________________

The 10th Anniversary “Yellow Dress” Celebration of Life
Golf and Dinner Gala Hayfields Country Club June 11, 2012

Player Registration Form

1. Registration form is being completed for:	A COMPANY		AN INDIVIDUAL
Player #1 Name (Captain):	__________________________		Title:	__________________________
Company Address:	__________________________		City:	__________________________
Hndcp___________	State:	__________________	Zip:	__________________________
Shirt Size_________	Phone:	__________________	Fax:	__________________________
L/R Hand_________			Email:	__________________________

Player #2 Name:	__________________________		Title:	__________________________
Company Address:	__________________________		City:	__________________________
Hndcp___________	State:	__________________	Zip:	__________________________
Shirt Size_________	Phone:	__________________	Fax:	__________________________
L/R Hand_________			Email:	__________________________

Player #3 Name:	__________________________		Title:	__________________________
Company Address	__________________________		City:	__________________________
Hndcp___________	State:	__________________	Zip:	__________________________
Shirt Size_________	Phone:	__________________	Fax:	__________________________
L/R Hand_________			Email:	__________________________

Player #4 Name:	__________________________		Title:	__________________________
Company Address:	__________________________		City:	__________________________
Hndcp___________	State:	__________________	Zip:	__________________________
Shirt Size_________	Phone:	__________________	Fax:	__________________________
L/R Hand_________			Email:	__________________________

Sponsor Information ( Team Captain if this is a Golf Sponsorship)
Name: _________________________________	Check #________________
Company: ______________________________	Total Amount#___________________
Title: __________________________________	Make checks payable to: Kristin Rita Strouse Foundation We accept American Express, Mastercard and Visa (circle one) Number__________________________________ Exp Date_________________________________ Name on Card_____________________________ Billing Address for Card____________________________________ For More Information Call: 443 275-1897 Sharon Wieciech
Address: _______________________________
City/State/Zip: ___________________________
Office Telephone: _______________________
Cell or Home Telephone:__________________
Fax: __________________________________ Email: __________________________________
	For More Information Call: 410-667-9384 or 410-218-9777 - Doug Strouse Sharon Wieciech
Mail this Form along with the Player Registration Form and your Payment To:
The Kristin Rita Strouse Foundation 10709 Pot Spring Road Cockeysville, Maryland 21030