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

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About
How Can I Give?
Key Projects
Employees
Physicians

Register for
Take a Swing at Cancer Events

May 4 - May 6, 2025

Old Waverly Golf Club

Benefiting the North Mississippi Medical Center
Cancer Care Assistance Fund

Take a Swing at Cancer Brochure

Vendor Village Brochure

Honor Our Honorary Chair

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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

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

Name 1 for Evening Gala *

First

Last

Name 2 for Evening Gala *

First

Last

$5,000 Vendor

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

2.5 hours of display/networking at Vendor Village
Includes table & display space
Two tickets to evening gala
Your logo as a sponsor on Vendor Village and other event signage
One golf team during Monday & Tuesday's four-man scramble
Overnight accommodations (one room)

Golf Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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

2.5 hours of display/networking at Vendor Village
Includes table & display space
Two tickets to evening gala
Your logo as a sponsor on Vendor Village and other event signage
One golf team during Monday or Tuesday's four-man scramble
Overnight accommodations (one room)
Your logo as presenting sponsor on all event signage
The opportunity to set up a table at golf registration
Four evening reception tickets
Four-bedroom onsite condo for overnight accommodations

Golf Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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
Tuesday Golf Team
Gala Tickets
Overnight Accommodation
Tennis Tournament Registration

How many additional teams?

1
2
3
4
5

Addtional Gala Tickets?

1
2
3
4
5

Overnight Accommodation

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

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Sponsor

Sponsorships

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

Par

Hole Sponsorship
Your business name featured at a hole on Old Waverly golf course

Birdie

Hole Sponsorship
One golf foursome

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Eagle

Official driving range or putting green sponsor(s)
One golf foursome

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Double Eagle

Official driving range or putting green sponsor(s)
Premium signage
Two golf foursomes

Team 1

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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 - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Ace

Official lunch and dinner sponsor
Premium signage
Two golf foursomes
Two Gala tickets

Team 1

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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 - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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

Premium signage
Three golf foursomes (Monday and Tuesday)
Four Gala tickets
Four-bedroom condo onsite

Team 1

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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 - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

First

Last

Team 3

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

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 -$3,500.00
Monday Four-Person Scramble Team Registration - $1,500.00
Tuesday Four-Person Scramble - $1,500.00
Two Gala Tickets and Overnight Accommodations - $550.00
Gala Tickets -$150.00
Tennis Tournament (Sunday OR Monday) - $75.00
Tennis Tournament (Both Days) - $120.00
Golf Package - $50

Stay and Play

Our most popular option - reserve your spot early to secure the course of your choice
Team of four in Monday or Tuesday's four-person scramble (individuals who choose Stay and Play will receive priority for Monday play)
8 overnight tickets to Sunday evening gala
Overnight accommodations (four rooms)
Breakfast/lunch on Monday or Tuesday

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer 1 *

First

Last

Golfer 3 *

First

Last

Golfer 2 *

First

Last

Golfer 4 *

First

Last

Name for Overnight Accommodation *

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

Monday / Tuesday Four-Person Scramble Team Registration

Flight Preference

Monday - 8:15 AM
Monday - 1:30 PM
Tuesday - 8:15 AM
Tuesday - 1:30 PM

Golfer Name 1 *

First

Last

Golfer Name 3 *

First

Last

Golfer Name 2 *

First

Last

Golfer Name 4 *

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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