Hudson Valley National Foundation Registration Form

June 17
Mount Kisco Country Club

Mount Kisco, NY
 July 22
Fenway Golf Club

Scarsdale, NY
 September 9
Saint Andrew’s Golf Club

Hastings-on-Hudson, NY
This outing is dedicated in memory of
William E. Griffin

Secure Online Registration Form

Please note that fields with an asterisk (*) are required.

 Foursome at all 3 Clubs (discounted) - $6,000
 Foursome at 2 Clubs - $4,400
 Foursome at 1 Club - $2,200
 Individual Golfer at all three Clubs (discounted) - $1,500
 Individual Golfer at one club - $550

  Golfers Names: (No commas, please.)

Please check club(s):
 Mount Kisco   Fenway   Saint Andrew's 

I cannot attend or sponsor, but wish to be a Patron .00                                                                             


Please support the Foundation by sponsoring one of the following events
 Hole Sponsor - $500 (total for all 3 outings)

# of Outings
    Golf Cart Sponsor at $750 per outing .00
    Lunch Sponsor at $500 per outing .00
    Refreshment Sponsor at $500 per outing .00
    Locker Room Sponsor at $500 per outing .00
    Hole-in-One Sponsor at $500 per outing .00
    Driving Range Sponsor at $600 per outing .00
    Pitching Contest Sponsor at $600 per outing .00
    Cocktail Party Sponsor at $1,000 per outing .00
    Dinner Sponsor at $1,250 per outing .00

Please check club(s):
 Mount Kisco   Fenway   Saint Andrew's 

Dinner tickets at $100 per person .00

Total amount $  .00

*First Name:  *Last Name: 
*Address 1:  Address 2: 
*City:  *State: 
*ZIP Code:  *Email: 
*Daytime Phone #:  Evening Phone #: 

Company Name (If applicable)  
Name on Sign (If applicable)  

    *Credit Card Type: 
*Credit Card #: 
*Exp. Date:  /

After ensuring that all of the information above is correct,
please click the Submit Form Now button ONLY ONCE.
Multiple clicks of the Submit button will result in duplicate charges to your account.
An email confirmation will be sent to the email address you provided.

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Hudson Valley National Foundation
21 Scarsdale Road • Yonkers, New York 10707
For additional information Email: or call (914) 768-6801

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