Larksfield Place
A community for living
Front Desk (Reception)(316) 636-1000
Welcome Center & Sales Office(316) 858-3910
Larksfield Place entrance

Anniversary Classic Golf Tournament

Please register below.  Credit cards will be run upon check in  - Monday, September 24th.  If paying by check mail it to the address below.  Deadline to register is September 17th.

Larksfield Place Retirement Community, Inc
C/O Anniversary Classic Golf Tournament
7373 E. 29th Street N, Wichita, KS 67226

Name
Company
Address
Phone
Email

Team Details - $1000 per team

Captain
Shoe Size
Team Member 2
Shoe Size
Team Member 3
Shoe Size
Team Member 4
Shoe Size
Place me on a team ($250 for individual)
Shoe Size

Payment Method

Visa
Mastercard
Discover
Total ($)
Name as it appears on card
Credit Card #
Exp. Date
Security Code
Billing Address if not same as above
Signed
Date