21st Annual MPCH Golf Benefit Golfer/Donor Registration Form
Monday, June 16th, 2025 | Grand Falls Casino & Golf Resort Sponsored by: Frontier Bank
10:30 AM Registration | 11:30 AM Shotgun Start
I plan to participate in the MPCH Golf Benefit:
Yes ($150 per golfer & complete the TEAM SECTION of this registration).
Yes, I am a Platinum Level sponsor & registering up to 4 free golfers (complete the TEAM section of this registration).
Yes, I am a Gold Level sponsor & registering up to 2 free golfers (complete the TEAM section of this registration).
No, I am not attending but I am sending a donation (complete DONOR section).
TEAM SECTION ($150 per golfer if not a Platinum or Gold level sponsor)
*Even if you do not have a team of 4, you can still sign up & be matched with others at the event
Golfer #1
First Name
Last Name
What kind of golfer are you?
Regular ($150)
Platinum Level Sponsor (free)
Gold Level Sponsor (free)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Golfer #2
First Name
Last Name
What kind of golfer are you?
Regular ($150)
Platinum Level Sponsor (free)
Gold Level Sponsor (free)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Golfer #3
First Name
Last Name
What kind of golfer are you?
Regular ($150)
Platinum Level Sponsor (free)
Gold Level Sponsor (free)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Golfer #4
First Name
Last Name
What kind of golfer are you?
Regular ($150)
Platinum Level Sponsor (free)
Gold Level Sponsor (free)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
DONOR SECTION
Donor Contact Name
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Amount you are donating to MPCH Association:
Payment | Cash/checks to be mailed to PO Box 550, Rock Rapids, IA 51246 | Checks should be made to MPCH Association.
*
I will send my payment in the mail to MPCH (preferred method)
I will pay at the event on June 16th (check/cash only)
The MPCH Association thanks you for your support!
Any questions can be directed to Brian Eben at 712-472-2537 or briane@frontierbank.com.
Submit
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