For Participants

“Your support
is needed…
Catholic
Social
Single Golfer REGISTRATION
Name ______________________________________
Address_____________________________________
NOW MORE Services
of the Miami Valley
City _________________________Zip ___________ THAN EVER!”
Phone ( ________ ) __________________
Northern
Team REGISTRATION ________________________
Team Name
The Northern Board of Catholic Social
Services of the Miami Valley invites you to Counties
Golf Outing
Names of Golfers participate in its 15th annual golf outing.
Player 1_____________________________________
Proceeds from this event will help the agency
Player 2_____________________________________ maintain family and child counseling, senior
Player 3_____________________________________ services, adoption, pregnancy counseling and
parenting programs.
Player 4_____________________________________
All proceeds benefit
Programs help families of all faiths in Auglaize, the programs of
Captain Information: Darke, Miami, Mercer and Shelby Counties.
Catholic Social Services’
Name ______________________________________ Northern Counties
Address_____________________________________
City _________________________Zip ___________ Our Mission…
Phone ( ________ ) __________________ Catholic Social Services of the Miami Stillwater Valley
Valley strengthens individuals and Golf Club
___ I cannot play this year but would like to make families through actions of faith,
____ dinner reservations at $30 each. service and charity. Versailles, Ohio
Friday, May 21, 2010
____ I wish to pay by ___ Mastercard ___ Visa Catholic
Card # __________________________________________ Social
Expiration Date ____________ Services
of the Miami Valley
Signature _______________________________________
Catholic Social Services
____ I wish to pay by check. of the Miami Valley
Payable to: Catholic Social Services-North, 1201 Fairington Drive
922 W. Riverview Ave., Dayton OH 45402 Sidney OH 45365
Your payment is your reservation.
Sorry, no refunds for cancellations after May 14.
“Play Where the Champions Ways to Participate For Sponsors
Play” Raffle n Golfer
$70
n Green fees and caddies for three at Muirfield (Includes 1/2 cart, greens fees and dinner)
Village Golf Club in Dublin, Ohio (Home of ___________________________________________
Name of sponsor
the Memorial Tournament)
n Dinner Guest Only ___________________________________________
n Tickets are $10 each. Only 500 will be sold. $30 Address
Contact Jim Bernhold, [email protected];
n Contribution to CSSMV ___________________________________________
David Galbreath, davidgalbreath@galbreathgmac. City State Zip
com; Pastor Doug Klinsing, greenvillecma@em-
barqmail.com; Mary Stueve, bmstueve@nktelco. n Tee Sponsorship ( _________ ) ______________________________
net; Kim Custenborder, [email protected] Phone
$100
or visit www.cssmv.org to purchase tickets. (Includes prominently displayed sign on Type of Sponsor: q Tee q Cart q Par
tee area)
q Tournament
The Event n Cart Sponsorship
q Contribution to CSSMV
$150
Friday, May 21, 2010 (Includes prominently displayed sign on
Stillwater Valley Golf Course cart) Please return form by May 14, 2010.
9235 Seibt Road n Par Sponsorship
Versailles, Ohio $350
____ I wish to pay by ___ Mastercard ___ Visa
(Includes golf foursome & prominently
displayed sign on tee area) Card # __________________________________________
The Schedule n Tournament Sponsor
Expiration Date ____________
Signature _______________________________________
Registration 11:00 a.m. $750
(Includes golf foursome and banner ____I wish to pay by check.
Scramble-Shotgun Start 12 noon recognition) Make payable to: Catholic Social Services-
North,
___ I cannot play this year but would like to make
Players may purchase mulligans (4 for $20) a contribution to CSSMV of $______.
• A kick • A skirt
• A throw • A mulligan
Special Prizes Your payment is your reservation.
Sorry, no refunds for cancellations after May 14.
n Best Team Score
Buy a pro’s tee shot ($5 on all par 5 holes) Detach and mail to:
n Skill Prizes
Catholic Social Services of the Miami Valley
Dinner 922 W. Riverview Avenue
Immediately following the tournament, all Dayton OH 45402
players are invited to attend the tournament For more information:
dinner. 937-214-1126 or 1-800-521-6419 ext. 141 All proceeds benefit the programs of Catholic
Email: [email protected] or Social Services’ Northern Counties which serve
Guests are welcome to attend the dinner. visit www.cssmv.org or befriend CSS Auglaize, Darke, Miami, Mercer and Shelby
Cost for non-players is $30 per meal. on Facebook to learn more Counties.