F O U N D A T - Avita Health System

Is proud to be the title sponsor of the
8th ANNUAL
A V I TA H E A LT H
F O U N D AT I O N
Walt Chambers
GALION CARDIAC REHAB SERVICES
MEMORIAL GOLF OUTING
• Galion Hospital Cardiac Rehab - Certified by
the American Association of Cardiovascular
and Pulmonary Rehabilitation
• More than 8,000 patient visits in 2014
• Provides clinically supervised exercise and
education to heart patients
• Exercise sessions available three times
weekly by highly-trained nurses and a
certified clinical exercise specialist
• Outpatient maintenance programs
Since 2008, the Walt Chambers Golf Outing
has helped with much needed equipment
upgrades for the Galion Hospital Cardiac
Rehab Department such as:
TOTAL BODY ERGOMETER
WEIGHT MACHINES (2)
ROWING MACHINES (2)
COMMERCIAL GRADE TREADMILLS (3)
PATIENT EDUCATION DVDs (12)
SCHWINN STATIONARY BICYCLES (2)
LAPTOP COMPUTER FOR PATIENT EDUCATION
UPPER BODY ERGOMETER
PORTABLE ELECTRONIC SCALES
RECUMBENT STEPPER
ELLIPTICAL MACHINE
SCOTT CARE TELEMETRY
A V I TA H E A LT H
F O U N D AT I O N
269 Portland Way S
Galion, OH 44833
AV
FO
For additional information, contact:
Tammy Schott - 419-468-0566
Patti Scott - 419-462-4616
Online registration:
www.avitahealth.org/waltchambers.html
GALION COUNTRY CLUB
GALION, OHIO
THURSDAY, JULY 16, 2015
SPONSORSHIP OPPORTUNITIES
8th ANNUAL WALT CHAMBERS
MEMORIAL GOLF OUTING
THURSDAY, JULY 16, 2015
Ace Sponsor - $1200
• Company name/logo prominently displayed
at registration
• Entry for four (4) players, greens fees, cart,
lunch, and dinner
• Company will receive a full page ad in
event program
• Podium recognition at dinner
• Company logo/name listed on hospital/golf
outing website
• Signage at one tee
• Galion Country Club
4810 St. Rt. 309
Galion, OH 44833
• Check-in at 10:00 a.m.
Shotgun Start at 11:00 a.m.
Dinner at 5:00 p.m.
Eagle Sponsor - $600
FORMAT
•
•
•
•
• Company will receive 1/2-page ad in
event program
• Podium recognition at dinner
• Company name listed on hospital/golf
outing website
• Signage at one tee
Four Player Scramble
Men’s Division (includes co-ed teams)
Women’s Division (women only)
Field Limit: 36 Teams
ENTRY FEE
Includes green fees, cart, lunch, dinner,
and prizes
•$100/Individual
•$400/Team
REGISTER TWO WAYS!
• By mail using the enclosed form
• Online at:
www.avitahealth.org/waltchambers.html
IN MEMORY OF WALT CHAMBERS
Walt was an avid golfer and beloved
member of the Galion community. He found
delight in playing his favorite sport with
his family and friends, both near home
and across the globe. Walt was openly
appreciative of the services in Galion
Hospital’s Cardiac Rehab Department
after becoming a patient there several
years ago. He quickly became friends with
the staff and fellow patients during his
recovery time.
Today, the Walt Chambers Memorial
Golf Outing provides a great legacy on
Walt’s behalf. This annual golf outing is
dedicated to the memory of Walt, and
helps provide financial support for cardiac
rehabilitation services and equipment
upgrades at Galion Hospital.
We look forward to another wonderful day
of fun and great golf. . . Please join us!
Don’t Wait!
Make your reservation today. Space is
limited and this event is full by June.
Cart Sponsor - $400
• Company/individual name featured on all
golf carts
• Company will receive 1/4-page ad in event
program
• Company name listed on hospital/golf
outing website
• Podium recognition at dinner
• Signage at one tee
Birdie Sponsor - $250
• Company will receive 1/4-page ad in
event program
• Podium recognition at dinner
• Company name listed on hospital/golf
outing website
• Signage at one tee
Par Sponsor - $150
• Company will receive listing in event program
• Company name listed on hospital/golf
outing website
• Signage at one tee
Contest Sponsor - $150
• Company/individual name featured on hole
where contest takes place
• Company will receive listing in event program
• Company name listed on hospital/golf
outing website
• Up to eight contests in all
TEAM/INDIVIDUAL
GOLFER ENTRY FORM (Deadline: July 3, 2015)
18-Hole Tournament
$100/person or $400/team
Total Fees Enclosed $_____________________
DINNER ONLY RESERVATIONS
Dinner $40/person
™I will not be golfing but would like to
participate in the evening dinner.
NAME OF DINNER GUESTS:
Division (please check one)
™Women’s Division
™Men’s Division
1.__________________________________________________________________
___________________________________________________________________
___________________________________________________________________
TEAM CAPTAIN
NAME
___________________________________________________________________
HOME ADDRESS
___________________________________________________________________
HOME ADDRESS
PHONE
___________________________________________________________________
___________________________________________________________________
CITY/STATE/ZIP
E-MAIL
PHONE
___________________________________________________________________
E-MAIL
___________________________________________________________________
GOLFER 2
___________________________________________________________________
HOME ADDRESS
___________________________________________________________________
CITY/STATE/ZIP
___________________________________________________________________
E-MAIL
___________________________________________________________________
GOLFER 3
___________________________________________________________________
HOME ADDRESS
___________________________________________________________________
CITY/STATE/ZIP
___________________________________________________________________
E-MAIL
___________________________________________________________________
GOLFER 4
___________________________________________________________________
HOME ADDRESS
___________________________________________________________________
CITY/STATE/ZIP
___________________________________________________________________
E-MAIL
Dinner Choice
______# of Chicken
______# of Beef
™ Ace Sponsor - $1200
™ Eagle Sponsor - $600
™ Cart Sponsor - $400
™ Birdie Sponsor - $250
™ Par Sponsor - $150
CITY/STATE/ZIP
___________________________________________________________________
___________________________________________________________________
SPONSORSHIP COMMITMENT
2.__________________________________________________________________
™ Contest Sponsor - $150
___________________________________________________________________
INDIVIDUAL/BUSINESS NAME
NAME
___________________________________________________________________
HOME ADDRESS
___________________________________________________________________
CONTACT PERSON
___________________________________________________________________
CITY/STATE/ZIP
___________________________________________________________________
___________________________________________________________________
ADDRESS
PHONE
___________________________________________________________________
E-MAIL
___________________________________________________________________
CITY/STATE/ZIP
3.__________________________________________________________________
NAME
___________________________________________________________________
___________________________________________________________________
PHONE
HOME ADDRESS
___________________________________________________________________
CITY/STATE/ZIP
___________________________________________________________________
PHONE
___________________________________________________________________
E-MAIL
Dinner Choice
______# of Chicken
______# of Beef
Total Amount Enclosed $_______________
Please return to:
Avita Health Foundation
269 Portland Way S, Galion, OH 44833
419-462-4616
pscott@avitahs.org
Deadline: July 3, 2015
Total Amount Enclosed $_______________
™Please invoice
™Check included
Please return to:
Avita Health Foundation
269 Portland Way S
Galion, OH 44833
419-462-4616
pscott@avitahs.org
Deadline: July 3, 2015