Contact Name

Email Address

Address

Phone Number

Please Check One: (For more than 1 team see options below) Please Check One: (For more than 1 team see options below) Title Sponsor ($5,000) Community Sponsor ($1,200) 4 Man Team ($500) Individual Player ($125)

Team Name (Title Sponsor , Community Sponsor Only)

4 Man Team Player Names

1st Team member

2nd Team Member

3rd Team Member

4th Team Member

For Title Sponsor 2nd Team Only

Team Name 2nd Team

Payment (All Checks Should be Mailed to P.O. Box 250, Bethany, LA 71107) Payment (All Checks Should be Mailed to P.O. Box 250, Bethany, LA 71107) Pay by Check Invoice Me

SMS Consent: SMS Consent: I have read the Privacy Policy/Terms & Conditions, and I consent to receiving SMS from Bethany Camp & Conference Center. Message and data rates apply; Messaging frequency may vary - https://bethanyc3.com/privacy-policy/ I do not consent.