Lung Cancer Golf Classic In Buies Creek

Lung Cancer Golf Classic
In Buies Creek
Keith Hills Golf Club
216 Country Club Drive
Buies Creek, NC
The 6th Annual Lung Cancer Golf Classic in
Buies Creek, established in memory of Thom
Wood, provides an opportunity for lung cancer
advocates, survivors and the community to
come together to raise awareness and support
to fight this disease. The net proceeds from
this event will benefit the Lung Cancer
Initiative’s research, education, awareness &
access programs.
The Event
- Four-person, Captain’s Choice tournament
- Registration includes green fee for 18 holes,
range balls, cart, and lunch
- Awards for top teams
- Putting contest
- Prizes for closest to the pin, longest drive
and more!
- Fantastic door prizes available
- Mulligans available for purchase on event day
- No rain date will be scheduled
Saturday,
May 2, 2015
12:00 PM Shotgun Start
Schedule of Events
10:30 – Event Day Registration (Range available)
11:00 – Lunch available
11:45 – Rally/Rules of play
12:00 – Shotgun start
5:00 – Awards Ceremony
Participation Opportunities
Tee Sponsor - $500
- Registration for 4 players included
- Sponsor’s name in text on one tee sign at event*
- Sponsor’s logo included on event webpage
Individual Players - $75 or $300 per foursome
Pin Flag - $125 (deadline: 4/14/15)
Dedicate a keepsake pin flag to promote your
business, or to honor a loved one. To order, see
registration form on back.
Registration Form
Lung Cancer Golf Classic Buies Creek
Registration Fees
(Must be received by Monday, April 27, 2015):
Complete this form and mail it with your credit card information or
enclose check(s) payable to Lung Cancer Initiative
$500 Tee Sponsor (includes 4 players)
$300 Foursome
$75 Individual (you will be placed on a team)
Please write Buies Creek Golf in the memo.
Send completed registration forms and payment to:
Lung Cancer Initiative of NC
4000 Blue Ridge Road, Suite 170
Raleigh, NC 27612
Registration Fee $_________
Tee Sponsor (includes 4 players) $_________
Player #1 (Captain) Name _______________________________
Pin Flag(s)* – Qty x $125 $_________
Street Address __________________________________________
City ____________________
State______
Additional Donation $_________
Zip ______________
Total $________
E-Mail _________________________________________________
Phone _________________________________________________
*Pin
Gender:
flag to say:__________________________________________
M/F
Handicap / Average Score _________________
I am a lung cancer survivor
Player #2 Name _______________________________________
E-Mail _________________________________________________
Phone _________________________________________________
Gender:
M/F
Handicap / Average Score _________________

I am a lung cancer survivor
Player #3 Name _______________________________________
E-Mail _________________________________________________
Phone _________________________________________________
Gender:
M/F
Handicap / Average Score _________________
I am a lung cancer survivor
Player #4 Name ________________________________________
E-Mail _________________________________________________
Phone _________________________________________________
Gender:
M/F
Handicap / Average Score _________________
I am a lung cancer survivor
Flag(s) ($125 ea.):
Please print what you wish the
___________________________________________________

 I’m using a logo (email KStelten@LungCancerInitiativeNC.org)
I am paying by:
Check
Cash
Visa
Mastercard
AMEX
Discover
Name on Card ___________________________________________
Card Number ____________________________________________
Exp. Date _____/______
CVC Code ______________
Billing Address __________________________________________
______________________________________________________
Players must sign the following event waiver on event day:
I, the undersigned, know that the event I am entering carries the risk of
personal injury or damage. I certify that I am physically fit for this event.
I hereby waive and forfeit all rights I may have to file suit or make claims
against Lung Cancer Initiative & the directors thereof, the City of Buies
Creek, NC, any sponsoring organizations & all persons connected with this
golf tournament for injuries I may suffer at this event on May 2, 2015. I
understand that no refunds can be made if the event is canceled due to
weather conditions or other circumstances beyond the control of the
organizers. I understand that from photos taken at the event, my
likeness may be used in future marketing and promotional materials for
the Lung Cancer Initiative of North Carolina.
Questions? Contact Khaki Stelten, Lung Cancer Initiative of North Carolina
P: (919) 784-0410 or KStelten@LungCancerInitiativeNC.org
Can’t make it to the event?
Use the above form to make a credit card, cash, or check donation, or purchase a
Pin Flag. You can also register online at BuiesCreek.kintera.org/2015
Visit LungCancerInitiativeNC.org for additional information.