Registration
2017 Jim Russell Foundation Summer Meeting
July 13-14, 2017
Name: ______
Spouse (if attending): ______
Children (if attending): ______
Company: ______
Address (C/S/Z): ______
Telephone: ______
______I will bring an auction item for the Jim Russell Foundation Auction.
Golf Packages
Golf Only $ 190.00______
(Includes green fees, cart, breakfast & lunch, and a beverage at course)
Golf & Meals $ 240.00 ______
(Meals include Golf Breakfast & Lunch, Summer Meeting Banquet)
Golf Lunch Only $ 30.00______
(To be served at 12:30pm at Bear Creek Valley Golf Club)
Fishing Tournament
Fishing Tournament Only $ 180.00______
Tournament & Meals $ 230.00______
(Meals include Summer Meeting Banquet)
TIOer Meeting010
Meeting Packages
(only if you are not registered for meal packages)
Summer Meeting Banquet $ 70.00______
Summer Meeting Banquet (Children 12 & under) $ 30.00 ______
TOTAL AMOUNT PAID: $ ______
Registration
2017 Jim Russell Foundation Summer Meeting
July 13-14, 2017
Name: ______
Spouse (if attending): ______
Children (if attending): ______
Company: ______
Address (C/S/Z): ______
Telephone: ______
______I will bring an auction item for the Jim Russell Foundation Auction.
Golf Packages
Golf Only $ 190.00______
(Includes green fees, cart, breakfast & lunch, and a beverage at course)
Golf & Meals $ 240.00 ______
(Meals include Golf Breakfast & Lunch, Summer Meeting Banquet)
Golf Lunch Only $ 30.00______
(To be served at 12:30pm at Bear Creek Valley Golf Club)
Fishing Tournament
Fishing Tournament Only $ 180.00______
Tournament & Meals $ 230.00______
(Meals include Summer Meeting Banquet)
TIOer Meeting010
Meeting Packages
(only if you are not registered for meal packages)
Summer Meeting Banquet $ 70.00______
Summer Meeting Banquet (Children 12 & under) $ 30.00 ______
TOTAL AMOUNT PAID: $ ______
Registration
2017 Jim Russell Foundation Summer Meeting
July 13-14, 2017
Name: ______
Spouse (if attending): ______
Children (if attending): ______
Company: ______
Address (C/S/Z): ______
Telephone: ______
______I will bring an auction item for the Jim Russell Foundation Auction.
Golf Packages
Golf Only $ 190.00______
(Includes green fees, cart, breakfast & lunch, and a beverage at course)
Golf & Meals $ 240.00 ______
(Meals include Golf Breakfast & Lunch, Summer Meeting Banquet)
Golf Lunch Only $ 30.00______
(To be served at 12:30pm at Bear Creek Valley Golf Club)
Fishing Tournament
Fishing Tournament Only $ 180.00______
Tournament & Meals $ 230.00______
(Meals include Summer Meeting Banquet)
TIOer Meeting010
Meeting Packages
(only if you are not registered for meal packages)
Summer Meeting Banquet $ 70.00______
Summer Meeting Banquet (Children 12 & under) $ 30.00 ______
TOTAL AMOUNT PAID: $ ______
ty, MO 65102
Golf Tournament
Golf Tee Time: 8:00a.m.
Here are the names of my four team members:
1. ______
2. ______
3. ______
4. ______
Type of Payment: (circle one)
Check Enclosed MasterCard Visa Discover
Credit Card Number: ______
Card Expiration Date: ______
Name on Credit Card (Please print): ______
Signature: ______
Registration must be returned to MOAG
Registration must be returned to MO-AG no later than July 7, 2017
P.O. Box 1728 Jefferson City, MO 65102uly
Golf Tournament
Golf Tee Time: 8:00a.m.
Here are the names of my four team members:
1. ______
2. ______
3. ______
4. ______
Type of Payment: (circle one)
Check Enclosed MasterCard Visa Discover
Credit Card Number: ______
Card Expiration Date: ______
Name on Credit Card (Please print): ______
Signature: ______
Registration must be returned to MOAG
Registration must be returned to MO-AG no later than July 7, 2017
P.O. Box 1728 Jefferson City, MO 65102uly
Golf Tournament
Golf Tee Time: 8:00a.m.
Here are the names of my four team members:
1. ______
2. ______
3. ______
4. ______
Type of Payment: (circle one)
Check Enclosed MasterCard Visa Discover
Credit Card Number: ______
Card Expiration Date: ______
Name on Credit Card (Please print): ______
Signature: ______
Registration must be returned to MOAG
Registration must be returned to MO-AG no later than July 7, 2017
P.O. Box 1728 Jefferson City, MO 65102uly