Online Registration

May 2nd Golf Tournament Registration

Foursome Registration Form

Your Name

Title

Name of Your Organization

Address

City

State

Zip

Phone ( )

Fax ( )

E-Mail Address

Please provide the name and contact information for your golfers:

Golfer #1 Title

Company Email

Phone

Handicap or Average Score (last five rounds)


Golfer #2 Title

Company Email

Phone

Handicap or Average Score (last five rounds)


Golfer #3 Title

Company Email

Phone

Handicap or Average Score (last five rounds)


Golfer #4 Title

Company Email

Phone

Handicap or Average Score (last five rounds)

Tournament Fees

 Foursome: $500 Awards Dinner: $75

We thank you for participating in and being part of the success of our May 2nd charity Golf Tournament. All proceeds will support our pain management research.
In America alone, over 100 million people suffer from pain – and these are just those who seek medical care. Pain is often undiagnosed & untreated yet leads to reduced workplace productivity, hundreds of millions of dollars a year in medical expenses, and most importantly – has a dramatic and negative impact on an individual’s quality of life. We are working on an overall new approach to the identification and treatment of pain, one that promises to reduce the dependency on narcotics, while more quickly identifying and resolving the underlying problem early on.

Tournament fees include Breakfast, Lunch, and the Awards Reception. An opportunity to attend the Pro Clinic and participate in the Silent Auction are included as well. Participants attending the full day but not playing golf may register for the Reception Only.

For sponsorship opportunities and discounts on multiple foursomes, please contact Troy Joslin at 410-409-9070 or tjoslin@healthsolutionsresearch.org.

HSR is a 501(c)3 non-profit and all contributions, sponsorships, or donations are fully tax deductible

Please send Form, Artwork, and Payment to: HSR, 15200 Shady Grove Road, STE 305, Rockville, MD 20850, agupta@healthsolutionsresearch.org. Credit Card payment can be made online @ http://www.healthsolutionsresearch.org

HSR is a 501(c)3 non-profit and all contributions, sponsorships, or donations are fully tax deductible.