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Contact Information

Name & Email Address Required
Name *
Prefix
First *
Last *
Suffix
MI
Middle
Email *
Kim's Awareness may use your email address to contact your regarding your current registration. You may also opt in to receive future emails below.
Newsletter
 Please send me emails about future Kymbo Golf Outings and Kim's Awareness news. 
We promise these emails are infrequent and you may opt out at anytime.

Address
Street Address
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City
State / Province / Region
Postal / Zip Code
Country
Phone Number

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What is your preferred method of contact?
Kim's Awareness may contact you regarding your registration.
If you chose Other, please explain in the Additional Comments section at the bottom of this form.

How would you like to be notified of next year's Kymbo Golf Outing?
We would love to see you come back next year!

**If you wish to be notified by Facebook, then "Like" the Kim's Awareness page at facebook.com/kimsawareness.
**If you would like to be notified by Twitter, then follow us at twitter.com/kimsawareness.

Golf Outing/Dinner Registration

Registration
How many total golfers/guests are you registering?
If you are registering more than 5 guests, please use the box at the bottom of the registration form to detail how many and who your guests are.

Golf - $110 Per Golfer

Please list the members of your golf foursome (if known).
Golfer #1
Prefix
First
Last
Suffix
Golfer #2
Prefix
First
Last
Suffix
Golfer #3
Prefix
First
Last
Suffix
Golfer #4
Prefix
First
Last
Suffix

Dinner - $38 Per Dinner Guest

Please list your guests who are attending the dinner only and will not be golfing.
Dinner Guest #1
Prefix
First
Last
Suffix
Dinner Guest #2
Prefix
First
Last
Suffix
Dinner Guest #3
Prefix
First
Last
Suffix
Dinner Guest #4
Prefix
First
Last
Suffix
Additional Guests & Info
If you have more than 4 guests, please use the box at the bottom of the registration form to enter the remaining names.

Tee/Hole Sponsorship

You may sponsor a tee/hole at the golf outing for a donation of $100
 I would like to sponsor a hole for $100 
Hole Sponsorship
If you would like to sponsor a hole, please designate what verbiage (family name, company name, etc.) you would like displayed on your sign (limited to 4 lines)

Additional Donation

Donation Amount
Please designate if you would like to make an additional donation

Additional Comments

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