Second Annual GAP Charity Poker Tournament
Player Registration Form
November 2, 2017
5:30 PM to 10:30 PM
St. Ives Country Club
1 St. Ives Country Club Dr.
Johns Creek, GA 30097
The GAP Partners sincerely appreciate your support of the Second Annual GAP Charity
Poker Tournament on November 2, 2017 at St. Ives Country Club, Johns Creek, GA. Player
Registration donation includes cocktail dinner reception and 3 drink tickets.
Player Registration Donation: $225.00 per player
Player Name:_______________________
Company Name: ____________________
Address: __________________________
Phone: ____________________________
Email: ____________________________
Player Name:_______________________
Company Name: ____________________
Address: __________________________
Phone: ____________________________
Email: ____________________________
Player Name:_______________________
Company Name: ____________________
Address: __________________________
Phone: ____________________________
Email: ____________________________
Player Name:_______________________
Company Name: ____________________
Address: __________________________
Phone: ____________________________
Email: ____________________________
Please return this form to Meredith Rominger by email at
[email protected] by October 13, 2017.
Please remit your player registration donation of $225.00 per player made payable to
The Packard Center to:
Robert Packard Center for ALS Research at Johns Hopkins
ATTN: Suzie Connelly /GAP Poker Tournament
5801 Smith Avenue | McAuley Suite 110
Baltimore, MD 21209-3652
Pay Sponsorship Donation On-Line
Please contact Meredith Rominger with any questions you may have at (912) 667-4546 to
[email protected]