REGISTRATION FORM - 2nd ANNUAL FLYERS CHARITIES CELEBRITY GOLF INVITATIONAL

*Contact Person: *Phone *E-mail *Organization *Street Address: *City State/Province -- Make Selection-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces of Americas Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Outside US and Canada Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota St Pierre Miquelon Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory *Zip code Website: Sponsorship Level (check one): Gold Silver Bronze Reception Only Player 1 Name: USGA Index: Shirt or Vest Size: Company Name: Street Address: City: State/Province -- Make Selection-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces of Americas Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Outside US and Canada Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota St Pierre Miquelon Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip: Phone E-mail Player 2 Name: USGA Index: Shirt or Vest Size: Company Name: Street Address: City: State/Province -- Make Selection-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces of Americas Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Outside US and Canada Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota St Pierre Miquelon Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip: Phone E-mail Player 3 Name: USGA Index: Shirt or Vest Size: Company Name: Street Address: City: State/Province -- Make Selection-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces of Americas Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Outside US and Canada Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota St Pierre Miquelon Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip: Phone E-mail Player 4 Name: USGA Index: Shirt or Vest Size: Company Name: Street Address: City: State/Province -- Make Selection-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces of Americas Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Outside US and Canada Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota St Pierre Miquelon Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip: Phone E-mail *Payment Type: I would like to pay by credit card I would like to pay by personal check Please send me an invoice For additional information: Phone: 215-389-9426 Fax: 215-389-9507 Email: MThomson@comcast-spectacor.com Website: www.comcastspectacorfoundation.org Waiver: In consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release all organizers and sponsors of this event from all claims of liability of any kind arising out of my participation in this event.

Thank You!