On the Registration Form, please
check the option you prefer:
Option 1: Form a 4-person team
with a 7:30am shot gun start.
Option 2: Form a 4-person team
with a 1pm shot gun start.
Option 3: Be placed on a morning
team.
Option 4: Be placed on an
afternoon team.
Option 5: Attend the dinner only.
Total Joint Replacements (TJRs)
For each golfer, please indicate the
number of total joint
replacements they have had. You do
not have to have a total
joint replacement to play.
Fees
All fees include 18-hole greens fee,
golf cart, give-aways, meal
package, awards, prize drawings and a
wonderful day of fun.
Discounted fees are offered to those
who have had total joint
replacement.
For each golfer, please circle
whether they will be attending
the dinner.
Registration Deadline
Registration for the shot gun tee-off
times are on a "first-come,
first-serve" basis. So register early
if you have a preference!
Registration with payment is due by
Mon, May 24th, 2004.
Registration Form
Make checks payable to: United
Health Services Foundation
Mail registration form and fee to:
United Health Services Hospitals
President's Office
10-42 Mitchell Avenue
Binghamton,
New York 13903
For More Information
Contact: Dianne Hudock
Phone: 762.2951
E-mail:
dianne_blaisure-hudock@uhs.org