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22nd Annual Helias Foundation Golf Tournament
Monday, September 13, 2010

Entry Fee: $140 per Person ($160 at Jefferson City Country Club)
                   $560 per Team ($640 at Jefferson City Country Club)

 

Online Payment Form
Registration Payment
I would like to:
  pay for a single registration only ($140)
        Provide player's Name:
pay for the entire team's registration ($560)
        Provide one or more players' names:
Please note that if you play at Jefferson City County Club, your $20 per player premium will be due at the course on the day of the tournament. Thanks for your understanding.
       
Add-Ons
Number of Non-Golfing Dinner Guests @ $15 each:
(Can also be paid at the door.)
 
 
Billing Information (Step i - Your Credit Card Information is Submitted via a Secure Server)
Enter the following information exactly as it appears on your credit card
Your Name:
Email:
Billing Address:
City:
State:
Billing Zip:
Phone:  xxx-xxx-xxxx
       

Your payment is not complete until you enter your credit card information on the next step.

Online Payment is made via a Secure Server
 

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PO Box 694    Jefferson City, Missouri 65102    Ph: (573) 635-3808    Fx: (573) 634-3205     info@heliasfoundation.org
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