5th Annual
John R. Elliott “Be A Hero”
Memorial Golf Tournament
Hosted by: MediLink Homecare, Inc.
Registration Form

- Print out this form and mail to address at the bottom -

Name: _____________________________________________
Company: __________________________________________
Address: ___________________________________________
Phone: ____________________________________________
Fax: ______________________________________________
e-mail: ____________________________________________
Participant(s)
Player A: ___________________________________________
Player B: ___________________________________________
Player C: ___________________________________________
Player D: ___________________________________________
Sponsor(s):
How you would like your sign to read: _______________________________________________

Payment Enclosed:
Play Only (includes luncheon & banquet:) ______ @ $250 per player              
Ensign Sponsor _____ @ $300
Lieutenant Sponsor _____ @ $500
Lieutenant Commander Sponsor _____ @ $750
Commander Sponsor _____ @ $1,000
Captain Sponsor _____ @ $1,500
Admiral Sponsor _____ @ $2,500
Hero Sponsor _____ @ $5,000
Dinner Only (no golf) _____ @ $75

Total enclosed: __________

 

Thank You for Your Support!
Make checks payable to:
The Hero Campaign
Mail to: “Be A Hero” Golf Tournament
Attn: Anne DiRenzo
MediLink Homecare, Inc.
463 N. White Horse Pike, Hammonton, NJ 08037
Phone: 609-567-2241 • Fax: 609-561-9444

Tax ID#22-3760241 • 501(c)3 Registered Charity • NJ Charities Registration #CH1891800