Fields marked with an * are required

Please fill out the form below if you wish to pay with a credit card. You may also pay by check if you visit our check registration page.

Sponsorship Information

Please select your sponsorship choices.

YES! I will attend the Reception on May 23rdĀ (Complimentary to Charity Classic Golf and Tennis participants)

YES! I would like to donate an item or service to the Silent Auction. Please send me a Silent Auction Information Form

YES! You may list my name on the all materials pertaining to the Classic. Please indicate below how you would like your name to appear on these materials, or upload logo.


Personal Information

Please enter your personal information.


Credit Card Information

Please enter your Credit Card Information.

The (typically) 16 digits on the front of your credit card.
The 3 digit (back) or 4 digit (front) value on your card.
The name printed on the front of your credit card.
The month your credit card expires, typically on the front of the card.
The year your credit card expires, typically on the front of the card.