2ND ANNUAL THERESES MULLIGAN CHARITY GOLF TOURNAMENT

BENEFITTING DAVID SAMMELI

THERESE IS PAYING IT FORWARD
Saturday, October 25th, 2014

Cerbat Cliffs Golf Course

Check in: 7:30am

Shotgun Start: 9:00am
Register Online at: www.pleasedgolf.com
Register by phone: 928.293.5263 or 928.757.4663
Register by fax: 928.752.8491
Mail: Return registration form and payment to:
PLEASED Golf, Inc. a Non-Profit Corporation
Attn: B. Prudham
6485 E. Crumb Rd.
Kingman, AZ 86401
REGISTRATION FORM

Name: __________________________________________________________________
Company Name: __________________________________________________________
Address: ________________________________________________________________
City: ___________________________________________________________________
Daytime Phone: ___________________________________________________________
E-Mail Address: __________________________________________________________
Handicap: _______________________________________________________________
Cerbat Cliffs Golf Course
1001 Gates Ave
Kingman, AZ 86401
http://www.cerbatcliffsgolf.com/
Questions about registration email bprudham@pleasedgolf.com or call 928.293.5263
For additional information on the Tournament and Charities visit the website at www.pleasedgolf.com
Please list preferred playing partners:
1.______________________________________________________________________
2.______________________________________________________________________
3.______________________________________________________________________

Format
4 Person Scramble: In a scramble, each player tees off on each hole. The best of the tee shots is selected and all
players play their second shots from that spot. The better of the second shots is determined, and then all play their
third shots from that spot, and so on until the ball is holed.

Registration Fees include:

18 holes of golf, awards lunch reception, golf cart, range balls, great tee prizes .
Tee, Hole and additional sponsorship opportunities are available and greatly appreciated.
Mulligans are 2 per player for $10.00 (one used for each nine) and can be purchased during time of registration or at
check-in. Mulligans CAN NOT be used for the following: Hole in One, Long Drive, Closest to Pin and Putting
Contest.
Golfer - $75.00 ea or $300.00 foursome x _________________________ = $________________________________
Mulligan 2 per player $10.00 x________________________= $_________________________________________

Dinner/Silent Auction Saturday, October 11th at the Historic Central Commercial Building located at 4th
& Beale Street. Cocktails and Silent Auction viewing at 6:00 pm Dinner at 6:30. Dress in Old Hollywood
Style, (ladies) Betty Grable, Rita Hayworth, Joan Crawford and (men) Clark Gabble, Charley Chan, and
John Wayne.
Old Hollywood Dinner/Silent Auction $60.00 ea. ____________________= $_______________________________
Old Hollywood Dinner/Silent Auction $100.00 per couple. ____________________= $________________________

Grand Total -__________________________________________________________________________

PLEASED Golf, Inc.
6485 E. Crumb Rd
Kingman, AZ 86401
LIABILITY WAIVER
I, the undersigned, hereby waive, release and hold harmless Sponsors, PLEASED Golf, Inc., The David
Sammeli Family, Therese Haase, Jake the Rocket Man Taylor, all Volunteers involved with the tournament
and Cerbat Cliffs Golf Course and its employees/members from any liability of injury or loss through my
participation in this Charity Golf Tournament..

I further agree to indemnify David Sammeli and family, the Sponsors, PLEASED Golf, Inc., Therese Haase,
all Volunteers and Cerbat Cliffs Golf Course and its employees/members of any liability whether implied or
direct. I further understand that it is the intent of the PLEASED Golf sponsors this event in name only.
Enclosed please find check # ___________________ PAYPAL or Credit Card in the amount of
$____________________________________.
(Please make check payable to PLEASED Golf, Inc. and mail to the above address.)
Please charge the following credit card (circle one) or note my online payment:
Visa - MasterCard Discover #______________________________________ CVV#_______________

In the amount of $_________________________________ Exp Date__________________________

Signature ____________________________________________________________________________

Print Name___________________________________________________________________________