19th Annual Team Golf Outing Registration Form

Team Name (optional)

Team Captain *

First

Last

Email *

$175 - Name

Phone

Player 2 Name

Player 3 Name

Player 4 Name

Payment Type - $175 per player

Check - Make payable to Berkshire Valley Golf Course. Please mail to Berkshire Valley with completed form (28 Cozy Lake Road, Oak Ridge, NJ 07438)
Credit Card - please input information below

Payment - Golf Outing Registration

For credit card payments, the charge will be processed upon receipt and completion of this form.

Name on Credit Card

Credit Card Number

Expiration Date

Security Code

I understand and agree to abide by the following:

Payment Policy: Payment for the full amounts must be included. Payments will be processed upon receipt. Insufficient funds, returned check or refused credit card charge will incur a fee of $20. Please be advised that a 3% processing fee will be applied to all online registrations paid by credit/debit card. This fee covers the cost of credit card transactions and is non-refundable.

Cancellation Policy: All cancellations must be in writing and submitted to jklippel@kempersports.com. Cancellations received two weeks before the date of the program will be honored.

Payment - Golf Outing Registration

I understand and agree to abide by the following:

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