Registration Form

Please fill out the form below and click submit when you are finished. Thank you.

Please be sure to complete the payment section below:
Please indicate your choice of payment-either credit card or check

Credit Card Number:
Expiration Date:
Charge this amount to my credit card:

Checks are payable to: LPM Charitable Foundation
24 Main Street, Maynard, MA 01754-2506

Sponsorship and Player Package Registration

I would like to be a Titanium foursome Sponsor for $4,500

I would like to be a Platinum foursome Sponsor for $2,500

I would like to be a Gold Single Sponsor for $1,000

I would like to add an Additional Golfer for $400

Player Registration

Sponsorship Registration
I would like to be a Hole In One Sponsor for $3,000 I would like to be a Eagle Sponsor for $1,000 I would like to be a Birdie Sponsor for $750 I would like to be a Par Sponsor for $500

Additional Questions or Comments: