Today's Date
Last name
First Name
Street Address
City
State
Zip Code
Phone
Fax
E-mail
Certification #

Are you planning on golfing? YES NO

If yes, list names of people you wish to golf with and whether you plan on walking or using a cart (you will be notified of tee times during the week prior to play):

Registration Fee: There will be no registration fee for I.A.T.S. members. Others will pay food costs at registration.