2022 Conference & Trade Show GOLF OUTING Registration Wednesday, September 21, 2022: Shotgun Start 8:30a.mJack Frost Golf Course – 1 Clubhouse Dr, Blakeslee, PA 18610 Visit the Jack Frost Golf Course online at: https://www.jackfrostnational.com/ EWQA Fall '22 GOLF OUTING 1Primary Registration2Players / Team3Rentals & Sponsorships4Review & Submit Players$150ea. Includes Golf, Breakfast & Lunch (After Golf)Primary Golfer or Contact(Required) First Last Company Name(Required) Phone(Required)Contact Email(Required) Additional Email additional email such as a bookkeeper or manager who keeps track of events and registrationsCompany Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Names & Handicap of Team Players:How Many Players?(Required) Single ($150) Double ($300) Threesome ($450) Foursome ($600) Player 1 Name(Required) First Last Player 1 Handicap Handicap Player 2 Name(Required) First Last Player 2 Handicap Handicap Player 3 Name(Required) First Last Player 3 Handicap Handicap Player 4 Name(Required) First Last Player 4 Handicap Handicap Is there a Player You'd Like to be Paired With?(Required)We will do our best to make pairings if/as possible Yes No / Doesn't matter to me Name of Player or You'd Like to be Paired With(Required) First Last Are there Players You'd Like to be Paired With?(Required)We will do our best to make pairings if/as possible Yes No / Doesn't matter to me Name of Player(s) You'd Like to be Paired With(Required) First Last Name of Player(s) You'd Like to be Paired With First Last Total RENTALS & SPONSORSHIPSNeed Clubs? No Problem. How about a SponsorshipDo You Need Rental Clubs?(Required) Yes No Club Rental: Men's RIGHT-handed Club Rental: Men's LEFT-handed Club Rental: Women's RIGHT-handed Club Rental: Women's LEFT-handed Men's RIGHT-handed(Required) Price: $0.00 Quantity: How many would you like?Men's RIGHT-handed Renter Name(s)(Required)Name Add RemoveUse the '+' on the right to add rowsMen's LEFT-handed(Required) Price: $0.00 Quantity: How many would you like?Men's LEFT-handed Renter Name(s)(Required)Name Add RemoveUse the '+' on the right to add rowsWomen's RIGHT-handed(Required) Price: $0.00 Quantity: How many would you like?Women's RIGHT-handed Renter Name(s)(Required)Name Add RemoveUse the '+' on the right to add rowsWomen's LEFT-handed(Required) Price: $0.00 Quantity: How many would you like?Women's LEFT-handed Renter Name(s)(Required)Name Add RemoveUse the '+' on the right to add rowsWould You like to add a GOLF SPONSORSHIP?(Required) Yes No 2022 Sponsorships(Required) Golf Hole Sponsor ($150) Golf Breakfast ($350) Golf Ball Sponsor **Exclusive** ($650) 19th Hole Buffet/Luncheon ($450) Beverage Cart ($500) Golf Towel ($250) Golf Hole Sponsor(Required) Price: $0.00 Quantity: Score a hole in one, company name printed on tee sign Golf Breakfast Price: $0.00 Get everyone off to a good start. Signage. Golf Ball Sponsor **Exclusive** Price: $0.00 Company logo on golf ball sleeve and signage. 19th Hole Buffet/Luncheon Price: $0.00 Enjoy lunch while congratulating tournament winners! Beverage Cart Price: $0.00 Keep 'em from getting thirsty. Signage Golf Towel Price: $0.00 Keep it clean, folks! Signage Total Total Credit CardCard Details Cardholder Name Please Do Not Refresh or Leave Once You Have Clicked Submit. Page Will Refresh Automatically.NameThis field is for validation purposes and should be left unchanged.