RAIN DATE: WEDNESDAY, OCTOBER 25, 2023
(Rescheduled from Sept. 18th).

REGISTRATION: 10:00 am | SHOTGUN START-SCRAMBLE FORMAT: 11:00 am | RECEPTION AND DINNER: After golf

SOUTHINGTON COUNTRY CLUB | 150 Savage Street, Plantsville, CT

Event Sponsors

Jim Langlois Memorial Trophy Sponsor

___________________________________ONLINE REGISTRATION FORM___________________________________________
Contact: Jean Barlage at jbarlage@ctconstruction.org.

REGISTRATION CONTACT

Company Name *

Contact Name (First and Last) *

Contact Email *

Cell Phone *

GOLF REGISTRATION: Golfer Cost: $190 Per Person or $760 per Foursome

Includes: 18 holes of golf, cart, driving range, lunch, beer, soda and water during golf, reception and BBQ Buffet dinner.

Check Foursome or Single Players Box if applicable. Submit golfer names and include the company name (only if different than the foursome leader).

Foursome $760

Single Player(s): $190 per person

Total No. of Golfers

Golfer 1: Full Name Foursome Contact

Golfer 2: Full Name and Company (if different)

Golfer 3: Full Name and Company (if different)

Golfer 4: Full Name and Company (if different)

Additional Golfers: Please Type Names and Company (if different)

DINNER GUEST(S) ONLY

Dinner ONLY cost: $75.00 per person. Includes reception and dinner (cash bar).

Total No. of Dinner ONLY Guests

Dinner Guest Name(s): Include company if different

SPONSORSHIP OPTIONS

Event Sponsor Gets Company Logo on flyer; is featured on event welcome sign, email notifications and on CCIA website.
Trophy sponsor includes company logo on sign and website.
All sponsors get company logo and/or name on signage and verbal recognition.

Please email your company logo to Jean Barlage by Sept. 8th: jbarlage@ctconstruction.org.

Select Sponsorship

$1000 Event Sponsor

$450 Jim Langlois Memorial Trophy Sponsor

$500 Dinner Sponsor

$500 Lunch Sponsor

$300 Longest Drive Contest Sponsor

$300 Closest to the Pin Contest Sponsor SOLD

$250 Hole in One Sponsor SOLD

$200 Tee Sign Sponsor

No Sponsorship

Clear Selection

Raffle Donation Options

Bring raffle item donation to outing

Will drop off raffle donation to CCIA Office

Will Make Raffle Cash Donation

Clear Selection

Raffle Cash Donation Amount $

TOTAL $ DUE:

Golfer Cost: $190 Per Person or $760 per Foursome
Dinner Only Guests: $75 Per Person

$ Total Golf Cost *

+

$ Total Sponsorship

+

$ Total Dinner ONLY

=

$ Total Payment Due *

Payment Options *

Mail Check

Credit Card (link to pay by credit card will be provided upon form submission)

Clear Selection

To make payment, mail check or pay by credit card upon submission of this online registration.

Make checks payable to CRMCA & Mail to:
CRMCA
912 Silas Deane Highway, Suite 112
Wethersfield, CT 06109

Contributions or gifts to CRMCA are not deductible as charitable contributions for Federal income tax purposes.

Fields marked with * are required.

Your form submission WILL be encrypted using SSL to ensure your privacy.

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REGISTRATION CONTACT

GOLF REGISTRATION: Golfer Cost: $190 Per Person or $760 per Foursome

Check Foursome or Single Players Box if applicable. Submit golfer names and include the company name (only if different than the foursome leader).

DINNER GUEST(S) ONLY

SPONSORSHIP OPTIONS

TOTAL $ DUE:

Golfer Cost: $190 Per Person or $760 per Foursome Dinner Only Guests: $75 Per Person

+

+

=

To make payment, mail check or pay by credit card upon submission of this online registration.

Make checks payable to CRMCA & Mail to: CRMCA 912 Silas Deane Highway, Suite 112 Wethersfield, CT 06109

Contributions or gifts to CRMCA are not deductible as charitable contributions for Federal income tax purposes.

Calendar

Golfer Cost: $190 Per Person or $760 per Foursome
Dinner Only Guests: $75 Per Person

Make checks payable to CRMCA & Mail to:
CRMCA
912 Silas Deane Highway, Suite 112
Wethersfield, CT 06109