Kentucky Derby Festival

Foundation Golf Scramble Form

Team/Organization Name:*

Please provide your team name or organization name.
Team Member 1 (Team Captain):
Name*
First Last
Email*
Phone
Polo Size*
Please select the polo size for player 1.
Team Member 2:
Name*
First Last
Email*
Phone
Polo Size*
Please select the polo size for player 2.
Team Member 3:
Name*
First Last
Email*
Phone
Polo Size*
Please select the polo size for player 3.
Team Member 4:
Name*
First Last
Email*
Phone
Polo Size*
Please select the polo size for player 4.
Payment Information
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Shepherd Insurance Kentucky Derby Festival Foundation Golf Scramble Team*
Price:
Hole Sponsor Yard Sign Quantity
Price: $100.00
If you would like to purchase a Hole Sponsor Yard Sign, please insert the amount of hole sponsorship you would like to purchase. $100.00 Per Hole Sponsor.
Total
$0.00
Credit Card
Card Details
Cardholder Name