Please complete each of the following fields to register for, or donate to, the 2018 Superior Health Foundation Golf Outing.

If you are registering on behalf of someone else, please include their name(s) in the Comments field.

First Name:

Last Name:

Company:

Address Line 1:

Address Line 2:

City:

State:

select

Zip Code:

E-Mail:

Phone Number:

Registration Type/Donation:

select

Amount:

Comments/Golfer Name(s):

* REQUIRED FIELDS

You will need to enter your credit card information in the next step.