14th Annual Dave Kiebach Memorial Golf Outing DKM Golf Outing - September 20, 2021 REGISTRATION FORM First Name *Last Name *CompanyPhoneEmail *As a reminder, last year we filled the field by mid August and the outing was SOLD OUT, so be quick to submit your RSVP!Golfer 1: Name *Golfer 2: NameGolfer 3: NameGolfer 4: NamePARTICIPATION OPTIONS Pin Flag Sponsorship $3500 (limit 3) - one golf foursome - exclusive six-hole pin flag sponsorship (logo included on flag) - commemorative framed pin flag - logo included on event and web communications Souvenir Bag Sponsorship $2500 (limit 1) - one golf foursome - exclusive sponsor of golf outing souvenir bag - logo included on event and web communications Smile Fund Sponsorship $1500 (limit 5) - one golf foursome - company logoed signage on player's golf carts - logo included on event and web communications Birdie Sponsorship $1000 - one golf foursome - signage at one golf hole - logo included on event and web communications - opportunity to provide item for souvenir bag Poker Run Sponsorship $750 - logo included on all cards used during poker run game - logo included on event and web communications Beverage Cart Sponsorship $500 (limit 4) - company logoed signage on 3 beverage carts - logo included on event and web communications 19th Hole Sponsorship $500 (limit 2) - exclusive signage on putting green and '19th' hole - logo included on event and web communications Par Sponsorship $150 - signage at one golf hole - logo on event signage Golf foursome $700 Individual Registration $175 Optional: Item to donate to Silent AuctionOptional: Amount to be donated to the David H Kiebach Smile FundPAYMENT INSTRUCTIONS PLEASE NOTE: Payment must be received by Friday, September 10, 2021Make check(s) payable to: Dave Kiebach Memorial Golf Outing Please include the last names of your foursome in the memo. Mail Payment to: Emilie Gerbers 1301 Perry Rd., Plainfield, IN 46148Total amount to be paid *Print a copy of this form before you hit submit.Test Upload FieldSignature TestClearSubmitPlease Wait... Success! Something is wrong with your submission.
