Individual Registration

Come play with us!

Join us for a morning of Topgolf, followed by a fajita lunch buffet on October 7, 2017, 9:00 a.m. – 1:00 p.m. All proceeds benefit The Jackson Project which was founded in honor of Jackson Wallace, affectionately known as J-Bird, who battled a fatal form of Leukodystrophy known as Krabbe Disease. Your participation helps Leukodystrophy families across the country!

Ready to register?

Registration is open until September 22, 2017. Register below or contact us if you have any questions.

Step 1: Individual Registration Form

If you would like to register as a business, please visit our Corporate Registration page.

* Contact Name

First

Last

* Phone Number

* Email Address

* Choose your ticket option: Individual Partner ($100 per player) Individual "Buy a Bay" Partner ($540 per bay, up to 6 players) Individual Partner Hero ($200 per player)

See ticket descriptions at the top of this page.

* How would you like your tickets delivered?

Email (print at home)

Mail

Mailing Address (for ticket delivery)

Street Address

Address Line 2

City

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State

ZIP Code

Step 2: Pay Registration Fee

You may pay the registration fee through Paypal by clicking on the button below.

Pay registration fee
(type amount on next page)

Step 3: Spread the Word!

• Like The Jackson Project on Facebook