Simply Well Golf Tournament 2016

Registration and Payment Options

The Simply Well annual golf tournament is going to be held on August 14th at Orchard Vali in Lafayette (9am shotgun start). This is a Captain and Crew tournament and teams must have at least one Crouse employee.

Includes 18 holes of golf with a cart, hotdog with water or soda at the turn, and a prime rib dinner at the end of the tournament. Individual skill prizes awarded and participants receive door prizes donated by the Crouse Simply Well Team.

The cost is $55 per participant, please indicate payment option below (including payroll deduction option).

Question Title

* 1. Please enter your information.

First Name

Last Name

Crouse Employee #

Email address

Phone number

Question Title

* 2. List the first and last names of your other THREE team members
Each team must include at least one Crouse employee, individuals or partial teams accepted to be placed in a foursome

Team Member 2 Name and Department (or indicate "non-employee")

Team Member 3 Name and Department (or indicate "non-employee")

Team Member 4 Name and Department (or indicate "non-employee")

Question Title

* 3. Your Preferred Payment Option
Payment is due by August 5th, team will not be registered until all members have submitted payment

Payroll Deduction (this form is the online payroll deduction)

Cash or Check (made payable to Sally Campbell) - deliver to the Employee Health Office (8 Memorial)

Question Title

* 1. Please enter your information.

Question Title

* 2. List the first and last names of your other THREE team members Each team must include at least one Crouse employee, individuals or partial teams accepted to be placed in a foursome

Question Title

* 3. Your Preferred Payment OptionPayment is due by August 5th, team will not be registered until all members have submitted payment

* 2. List the first and last names of your other THREE team members
Each team must include at least one Crouse employee, individuals or partial teams accepted to be placed in a foursome

* 3. Your Preferred Payment Option
Payment is due by August 5th, team will not be registered until all members have submitted payment