Team & Individual RegistrationFRONTIER SUPPLY COMPANY CHILDREN'S CHARITY GOLF CLASSICSPECIAL THANKS TO OUR 2022 PLANTINUM SPONSOR, REHAU!Team or Individual Player Registration Please register your team or yourself below.Team NameContact Name(Required) First Last Email(Required) Phone(Required)Address 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 Sponsorship and FeesTeam Registration (5 Players) Price: $1,000.00 Quantity: Individual Golfer Price: $200.00 Quantity: Player InformationGolfer 1 Name First Last Shirt SizeSelect OneSmallMediumLargeX Large2X Large3X LargeShirt TypeSelect OneMen's ShirtWomen's ShirtHandicap (preferred) or Average ScoreGolfer 2 Name First Last Shirt SizeSelect OneSmallMediumLargeX Large2X Large3X LargeShirt TypeSelect OneMen's ShirtWomen's ShirtHandicap (preferred) or Average ScoreGolfer 3 Name First Last Shirt SizeSelect OneSmallMediumLargeX Large2X Large3X LargeShirt TypeSelect OneMen's ShirtWomen's ShirtHandicap (preferred) or Average ScoreGolfer 4 Name First Last Shirt SizeSelect OneSmallMediumLargeX Large2X Large3X LargeShirt TypeSelect OneMen's ShirtWomen's ShirtHandicap (preferred) or Average ScoreGolfer 5 Name First Last Shirt SizeSelect OneSmallMediumLargeX Large2X Large3X LargeShirt TypeSelect OneMen's ShirtWomen's ShirtHandicap (preferred) or Average ScoreOptional Additional DonationDiabetes Kits Price: $32.00 Quantity: Contains books designed to help kids learn about and manage a new diabetes diagnosis.Respiratory Kits Price: $20.00 Quantity: Contains either NoseFrida or a spacer for use with inhaler.Infant Kits - HALO SleepSack Price: $12.00 Quantity: Sleep sacks encourage safe sleeping practices to prevent sudden infant death.Total Payment InformationPlease pick your payment option: Send Check to Greater Fairbanks Community Hospital Foundation Pay with Credit Card to Greater Fairbanks Community Hospital Foundation (see below) Send Check to Frontier Supply Company Credit on Frontier Supply Account Equivalent Value of Saleable Merchandise to FSCMail checks to Greater Fairbanks Community Hospital Foundation, ATTN FSC Golf Classic, PO Box 71396, Fairbanks, AK 99707 or Frontier Supply Company, ATTN Robyn Raker, 981 Van Horn Road, Fairbanks, AK 99701Credit CardAmerican ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged.
