Take A Swing At Cancer Registration – Health Care Foundation of North Mississippi

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- The Dr. Charles Montgomery Scholarship Endowment
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Home
About
How Can I Give?
Special Events
Special Projects
- The Dr. Charles Montgomery Scholarship Endowment
Employees
Physicians

Register for
Take a Swing at Cancer Events

May 3 - May 4, 2026

Old Waverly and Mossy Oak Golf Club

Benefiting the North Mississippi Medical Center
Cancer Care Assistance Fund

Take a Swing at Cancer Brochure

Vendor Village Brochure

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Registration Status

I am an NMMC Hospital Vendor
I would like to Sponsor the event
I would like to register as a participant

Vendor

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Company Name *

Notes or Requests

Email *

Do you plan to attend Vendor Village? *

Yes
No

Vendor Partnership Opportunities *

$3,000
$5,000
$7,500
$10,000

$3,000 Vendor Village Bronze Sponsor

1.5 hours of display/networking at Vendor Village
Includes table & display space
Two tickets to evening reception

Name 1 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

$5,000 Vendor Village Silver Sponsor

1.5 hours of display/networking at Vendor Village
Includes table/display space
Two tickets to evening reception
Your logo as a sponsor on Vendor Village and other event signage

Name 1 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

$7,500 Vendor Village Beverage Gold Sponsor

1.5 hours of display/networking at Vendor Village
Includes table/display space
Two tickets to evening reception
One golf team
Overnight accommodations on Sunday night (1 room)
Your logo as a sponsor on Vendor Village and other event signage

Golf Flight Preference

Monday, May 4th - 8:15 AM, Old Waverly
Monday , May 4th - 1:30 PM, Old Waverly
Monday, May 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Name 1 for Evening Gala *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Name 2 for Evening Gala *

First

Last

$10,000 Vendor Village Presenting Sponsor

1.5 hours of display/networking at Vendor Village
Includes table/display space
Four tickets to evening reception
Premium signage at Vendor Village
One golf team
Your logo as presenting sponsor on all event signage
Four evening reception tickets
Four-bedroom condo onsite

Golf Flight Preference

Sunday 3rd - 8:15 AM, Old Waverly
Sunday 3rd - 1:30 PAM, Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

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Golfer 1 *

First

Last

Golfer 3 *

First

Last

Name 1 for Evening Gala *

First

Last

Name 3 for Evening Gala *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Name 2 for Evening Gala *

First

Last

Name 4 for Evening Gala *

First

Last

Name for Overnight Accommodation *

First

Last

Do you need additional options?

Monday Golf Team
Gala Tickets
Overnight Accommodation
Tennis Tournament Registration

How many additional teams?

1
2

Golf Flight Preference

Monday, May 4th - 8:15 AM, Old Waverly
Monday , May 4th - 1:30 PM, Old Waverly
Monday, May 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Addtional Gala Tickets?

1
2
3
4
5

Overnight Accommodations?

1
2
3
4
5

Number of Tennis Players

1 Player (Sunday OR Monday)
2 Players (Sunday OR Monday)
3 Players (Sunday OR Monday)
4 Players (Sunday OR Monday)
5 Players (Sunday OR Monday
1 Player (Both Days)
2 Players (Both Days)
3 Players (Both Days)
4 Players (Both Days)
5 Players (Both Days)

Include names for each ticket holder

Include names for overnight registration

Include names for each tennis player, email, tennis level, and day playing

Golf Flight Preference 2

Monday, May 4th - 8:15 AM, Old Waverly
Monday , May 4th - 1:30 PM, Old Waverly
Monday, May 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Sponsor

Sponsorships

Par - $1,000.00
Birdie - $2,500.00
Eagle - $3,000.00
Double Eagle - $5,000.00
Ace - $7,500.00
Masters - $10,000.00
Tennis Tournament - $2,500.00

Par

Hole Sponsorship

Birdie

Hole Sponsorship
One golf team

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Eagle

Official Putting Green or Driving Range sponsor
One golf team

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Double Eagle

Official Courtesy Cart sponsor
Premium signage
Two golf teams

Team 1

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Team 2

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Ace

Official Lunch Sponsor
Premium signage
Two golf teams
Two Gala tickets

Team 1

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Team 2

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Other

Name 1 of Evening Gala *

First

Last

Name 2 of Evening Gala *

First

Last

Masters

Presenting Sponsor(s) Premium Signage
Four Gala tickets
Three golf teams (Sunday or Monday)
Four-bedroom condo onsite

Team 1

Flight Preference

Monday 4th - 8:15 AM, Old Waverly
Monday 4th - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Team 2

Flight Preference

Sunday 3rd - 8:15 AM, Old Waverly
Sunday 3rd - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Team 3

Flight Preference

Sunday 3rd - 8:15 AM, Old Waverly
Sunday 3rd - 1:30 PM Old Waverly
Monday 4th - 8:15 AM, Mossy Oak
Monday 4th - 1:30 PM, Mossy Oak

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Other

Name 1 for Evening Gala *

First

Last

Name 3 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

Name 4 for Evening Gala *

First

Last

Name for Condo Reservation *

First

Last

Tennis Tournament

Premium signage at golf & tennis tournaments
Two Tennis registrations

Name 1 of Tennis Player *

Name 2 of Tennis Player *

Email *

Email *

Tennis Level

Tennis Level

Participant

Ways to participate

Stay and Play - $4,000.00
Sunday Medal Play Tournament - $1,750.00
Monday Four-Person Scramble - $1,750.00
Two Gala Tickets and Overnight Accommodations - $550.00
Gala Tickets -$150.00
Tennis Tournament (Sunday or Monday) - $100.00
Tennis Tournament (Both Days) - $175.00
Golf Package - $100.00

Stay and Play (Sunday & Monday)

Our most popular option. Reserve your spot early.
Team of four in Sundal's Medal Play Tournament AND Monday's four-person scramble
8 tickets to Sunday night reception
Overnight accommodations (four rooms)
Breakfast/lunch on Monday

Sunday Flight Preference

Sunday May 3rd, Old Waverly (Tee time to be assigned)
Sunday May 3rd - Mossy Oak (Tee time to be assigned)

Monday Flight Preference

Monday, May 4th - 8:15 AM, Old Waverly
Monday, May 4th - 1:30 PM, Old Waverly
Monday, May 4th - 8:15 AM, Mossy Oak
Monday, May 4th - 1:30 AM, Mossy Oak

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Name 1 for Evening Gala *

First

Last

Name 3 for Evening Gala *

First

Last

Name 5 for Evening Gala *

First

Last

Name 7 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

Name 4 for Evening Gala *

First

Last

Name 6 for Evening Gala *

First

Last

Name 8 for Evening Gala *

First

Last

Sunday Medal Play Tournament

Sunday Flight Preference

Sunday May 3rd, - Old Waverly (Tee time to be assigned)
Sunday May 3rd - Mossy Oak (Tee time to be assigned)

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Monday Four-Person Scramble at Old Waverly & Mossy Oak

Flight Preference

Monday, May 4th - 8:15 AM, Old Waverly
Monday, May 4th - 1:30 PM, Old Waverly
Monday, May 4th - 8:15 PM, Mossy Oak
Monday, May 4th - 1:30 PM, Mossy Oak

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Name for Overnight Accommodation *

First

Last

Two Gala Tickets and Overnight Accommodations (One Room)

Name 1 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

Name for Overnight Accommodation *

First

Last

Gala Tickets

Tennis Tournament Sunday or Monday

Day

Sunday
Monday

Days

Both Sunday & Monday

Tennis Players Name and Levels

Tennis Players Name and Levels

Golf Package

Golf Package

How Would You Like to Pay? *

Pay Online
Invoice

Total

$0.00

Authorize.Net *

Card Number

Expiration

/

Security Code

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