The Dysautonomia Foundation is pleased to present:

In support of treatment and research for Familial Dysautonomia (FD)

Event Details   
Register to Play   Directions   
Sponsor the Event      Donate    

Registration Form
First Name:  
Last Name:  
Team / Club:
//   Specify a new team    Team not listed? - click here
Registration Fee: $775.00 per golfer
Registration Fee:
Mailing Address: Address 1
  Address 2
State / Zip:     
Phone Number: 10 digits only, no ( ) - symbols
Handicap: (required)
eMail Address:  
Method of payment: 
T-Shirt Size:
Names and handicaps of your foursome:
Additional Donation: $ Enter amount as dollars and cents (e.g., 25.00), do not type dollar sign
Display My Sponsors: Check this box if you'd like the names of your sponsors listed on the web page that shows the total amount you've raised for this event.
Enter numbers from the image: Captcha

The Dysautonomia Foundation is a registered 501(c)3 non profit organization.

Please visit the Dysautonomia Foundation's website for more information about FD and what we do.
Thank you for your support!

A copy of our latest annual report may be obtained upon request from the Dysautonomia Foundation at 315 W. 39th Street, Suite 701, NY, NY 10128,
or from the New York State Attorney General’s Charities Bureau at 120 Broadway, 3rd Fl., NY, NY 10271.

Copyright © 2018 Dysautonomia Foundation, Inc.