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21st Annual Putt Putt Golf Tournament
KISS Mini Golf
Thursday, November 14th, 2013
4:30 pm Registration
5:00 pm Putting - Shotgun Start
5:00 - 8:00 pm Open Lounge
Winners Announced in the Lounge after Play Ends
KISS Mini Golf
4503 Paradise Rd.
Las Vegas, NV 89169
Across the street from the Hard Rock Hotel
Check All That Apply - Indicate Quantity
Registration: Non-Members
Register by 11/11/2013
Registration: Members & Sponsors
Register by 11/11/2013
Grand Total:
***Free at the door for Members & Sponsors, $50 for Non-Members or Guests without Reservations by Registration Deadline. No Refunds after Monday, November 11th, 2013. Cancellations must be received by Fax or Email by Monday, November 11th, 2013. Substitutions are welcome. No-Shows Will be Billed.

***IF YOU PAY BY CREDIT CARD AND NEED A RECEIPT, PLEASE EMAIL SNCCIM@AMNEVADA.COM***
Name of Attendee
*E-Mail:Valid e-mail is required
*First Name:
*Last Name
Company:
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip Code:
*Phone:
Additional Attendees
Name of Guest (1)
Name of Guest (2)
Name of Guest (3)
Payment Information
Card Number:No dashes or spaces please
Expiration Month:From your card
Expiration Year:From your card
Card Brand:
CVV2:Card Security Code
The merchant name that will appear on your credit card receipt and statement is CCIM
Pay by CheckMail to address below
Pay at Door
Mail Payment To:
Southern Nevada CCIM
P.O. Box 97653
Las Vegas, NV 89193
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