Celebrity Registration
Fill out the Information below and you or your agent will be contacted.

Celebrity Name
Agent/Representative's Name
(If contact should be made through your Agent or Management Company)
Address
City
State
Zip Code

Contact Phone Number
(mobile preferred)
Contact Fax
Contact E-mail Address
 
Celebrity Handicap
 
Arrival Date
Arrival Time
Airline
Flight Number
Arriving In Own Vehicle?
 Yes No
Number Of Persons In Party?
Number Of Rooms Needed?
 

Yes, I WILL be attending the 5th Annual Yolanda D. Thomas Celebrity Golf Tournament.

No, I WILL NOT be attending the 5th Annual Yolanda D. Thomas Celebrity Golf Tournament.

I will be providing autographed auction item(s) to benefit the Yolanda D. Thomas Scholarship Endowment.
I authorize the use of my name, affiliation by name only and photos (head shot only) to be used in theadvertising, marketing, and direct mail brochures produced for the 2009 6th Annual Yolanda D. ThomasScholarship Endowment Celebrity Golf Tournament. No logos or photographs showing teamaffiliation or third party entity will be used or reproduced in association with this charity event.
   


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