Golfer Registration Name(Required) First Last Email(Required) Phone(Required)How many golfers are you registering for? (1-4)(Required)Please enter a number from 1 to 4.Golfer 1(Required) First Last Golfer 1 Email(Required) 1st Golfer's Shirt Size(Required)SmallMediumLargeExtra Large2 XL3 XL4 XL5 XLGolfer 2(Required) First Last Golfer 2 Email(Required) 2nd Golfer's Shirt Size(Required)SmallMediumLargeExtra Large2 XL3 XL4 XL5 XLGolfer 3(Required) First Last Golfer 3 Email(Required) 3rd Golfer's Shirt SizeSmallMediumLargeExtra Large2 XL3 XL4 XL5 XLGolfer 4(Required) First Last Golfer 4 Email(Required) 4th Golfer's Shirt SizeSmallMediumLargeExtra Large2 XL3 XL4 XL5 XLGolfer Fees Price: $0.00 Total How would you like to make your registration payment? I will make my payment now by credit card Pay later Platinum, Diamond, Butterfly, or Maddox level Sponsor (Golfer registration only) During check-out, golfers can pay by credit card. Golfers who choose the "Pay later" option can make payment via cash or check at the event or send funds via PayPal or Venmo using the How to Help - Donate page of this site.Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card Payment Information American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name If mailing a check, please submit the form and then mail your check to: The Butterfly Effect of Maddox J. LoPriore FoundationP.O. Box 265 Lake Villa, IL 60046 (This address will also be emailed to you after your submission).