40th Annual Backus Golf Tournament

Supporting the enhancement of the Backus Neonatal Intensive Care program

Registration is now open for the 40th Annual Backus Golf Tournament!

Tournament: Monday, June 7, 2021 at Lake of Isles, North Stonington.

Register using the online form below, or download the form and send with payment to Backus Hospital office of Philanthropy and Development, 326 Washington Street, Norwich, CT 06360.

Contact Gen Schies with any questions, genevieve.schies@hhchealth.org, (860) 823 - 6325.

Registration Type*

Sponsor
Golfer

Sponsor Name*

Sponsorship Level*

Number of Golfers*

Non Sponsor*

Number of Golfers*

Sponsors will receive priority player reservations.

Total

$0.00

Contact Information

Name*

First Last

Email*

Phone*

Address Information*

Street Address Address Line 2 City State ZIP Code

Ads*

Please use last year's ad.
My company will submit a new ad.
I will not be submitting an ad.

Upload your ad*

Accepted file types: jpg, gif, png, pdf, Max. file size: 128 MB.

Please submit either JPG, GIF, PNG, or PDF

Golfer Information

Please provide the information for the golfers in your party.

Please select the quantity of golfers in your party.

Golfer 1

Name

First Last

Company Name

Email

Phone

Address

Street Address City State ZIP Code

Golfer 2

Name

First Last

Company Name

Email

Phone

Address

Street Address City State ZIP Code

Golfer 3

Name

First Last

Company Name

Email

Phone

Address

Street Address City State ZIP Code

Golfer 4

Name

First Last

Company Name

Email

Phone

Address

Street Address City State ZIP Code

Payment

Payment Type*

Please accept my payment through Paypal
I will mail a check payable to Backus Hospital

Total

$0.00

Name

This field is for validation purposes and should be left unchanged.

Give to Backus

Supporting the enhancement of the Backus Neonatal Intensive Care program

Registration is now open for the 40th Annual Backus Golf Tournament!

Contact Information

Golfer Information

Please select the quantity of golfers in your party.

Golfer 1

Golfer 2

Golfer 3

Golfer 4

Payment

Give to Backus