$125 Per Person. Lansdowne Golf Club Woodridge Parkway Lansdowne, VA 20176
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1 To benefit the Georgetown University Hospital Neonatal Intensive Care Unit/Pediatrics and the March of Dimes April 4, :00 am Shotgun Start (Captain s Choice) $125 Per Person Lansdowne Golf Club Woodridge Parkway Lansdowne, VA Register online at Or, mail the completed application with check to: Katelyn Hall Foundation P.O. Box 1234 Leesburg, VA Make checks payable to the Katelyn Hall Foundation. Included: Cart and Green Fees Free Driving Range Goody Bag Breakfast, Lunch, & Awards Dinner Banquet Beverages on the Course Prize for Closest to the Pin on Selected Par 3 Prize for Longest Drive on Selected Hole Plus, Numerous Door Prizes This tournament is a Captain s Choice format. All rules will be announced by the golf professional prior to the starting of the event. Golfers may arrive as early as 7:30 am to use the free driving range. Upon arrival, please check in to receive your ticket for door prizes and other materials. Each player will be able to purchase Mulligan s. The shotgun start will begin promptly at 9:00 am. If any golfer does not have a foursome, we will match you with others to complete a foursome. Applications will be numbered as they are received and must be received by March 21 st, Katelyn Hall Foundation is registered with the Commonwealth of Virginia s Office of Consumer Affairs pursuant to the Virginia Solicitation of Contributions Law. A financial statement is available upon written request from the Office of Consumer Affairs. Contact the Office of Consumer Affairs at P.O. Box 1163, Richmond, Virginia (804) , Toll free in VA: (800)
2 Sponsor Registration Form Title Sponsor: $5,000 Banner with company logo at registration area Company logo on each tournament golf cart Largest logo and top placement on tournament tee shirts Full page of advertising in tournament program Two foursomes to participate in tournament, including all tournament amenities and awards banquet Company name mentioned in all press releases Podium recognition at awards dinner banquet Recognition Plaque Platinum Sponsor: $3,000 Company sign at selected location on golf facility Company logo and top placement on tournament tee shirts Company name and logo in tournament program Two foursomes to participate in tournament, including all tournament amenities and awards banquet Company name mentioned in all press releases Podium recognition at awards dinner banquet Recognition plaque Gold Sponsor: $1000 Company sign at selected location on golf facility Recognition plaque
3 Silver Sponsor: $500 Company sign at selected location on golf facility Recognition plaque Hole Sponsor: $300 Company sign at either tee or green Program Sponsor: $150 Breakfast Sponsor This sponsor will either provide breakfast or cover the cost of breakfast for each player prior to start Tee sign with company logo stating you are the breakfast sponsor Recognition during pre shotgun announcements Podium recognition at awards banquet Lunch Sponsor This sponsor will cover the cost of lunch or provide lunch boxes for each player while on the course Tee sign with company logo stating you are the lunch sponsor Recognition during pre shotgun announcements Podium recognition at awards banquet Company logo included on tournament website Thank you card on all golf carts featuring your company s name
4 Dinner Sponsor: This sponsor will cover the cost of dinner or supply dinner for each player at the awards banquet Company banner at awards banquet Recognition during pre shotgun announcements Podium recognition at awards banquet In Kind Donations: Silent Auction Items and Raffle Prizes Please your company logo to if applicable. If you have pre-printed materials for advertising (i.e. key chains, stickers, etc.), please make arrangements for pick-up by calling. Materials will be distributed to all participants prior to the start of the golf tournament. Also, please contact Michael or Ashley for any needed tax id information. All proceeds go to the Georgetown University NICU/Pediatrics and the March of Dimes. Silent Auction items will be posted on the tournament website ( as items are donated. -- Please detach & return this form to Katelyn Hall Foundation, P.O. Box 1234, Leesburg, VA by 3/21/2011. Make checks payable to the Katelyn Hall Foundation. You may also sign up and pay on-line at SPONSOR COMPANY NAME REPRESENTATIVE NAME ADDRESS CITY STATE ZIP PHONE LEVEL OF SPONSORSHIP If applicable, please list names for the number of golfers included in your sponsorship: PLAYER 1 PLAYER 5 PLAYER 2 PLAYER 6 PLAYER 3 PLAYER 7 PLAYER 4 PLAYER 8
5 Player Registration Form April 4, :00 am Shotgun Start (Captain s Choice) $125 Per Person Lansdowne Golf Club Woodridge Parkway Lansdowne, VA Included: Cart and Green Fees Free Driving Range Goody Bag Breakfast, Lunch, & Awards Dinner Banquet Beverages on the Course Prize for Closest to the Pin on Selected Par 3 Prize for Longest Drive on Selected Hole Plus, Numerous Door Prizes This tournament is a Captain s Choice format. All rules will be announced by the golf professional prior to the starting of the event. Golfers may arrive as early as 7:30 am to use the free driving range. Upon arrival, please check in to receive your ticket for door prizes and other materials. Each player will be able to purchase Mulligan s. The shotgun start will begin promptly at 9:00 am. If any golfer does not have a foursome, we will match you with others to complete a foursome. Applications will be numbered as they are received and must be received by March 28 th, All proceeds go to the Georgetown University NICU/Pediatrics and the March of Dimes. You will be notified if the tournament has sold out. Silent Auction items will be posted on the tournament website ( as items are donated. -- Please detach & return this form to Katelyn Hall Foundation, P.O. Box 1234, Leesburg, VA by 3/28/2011. Make checks payable to the Katelyn Hall Foundation. You may also sign up and pay on-line at NAME ADDRESS CITY STATE ZIP PHONE HAVE FOURSOME? PLAYER 1 PLAYER 2 PLAYER 3 PLAYER 4 Yes No
6 My Journey By Katelyn Hall I was born on Nov 16, 2003 at 25 weeks gestation via emergency C-section. I came into this world at such an early gestational age because my mom developed a life threatening condition and they had to deliver me to save her life. I weighed 15.5 oz and was 11 ¼ inches long. I had IUGR (Intra-Uterine Growth Restriction) and was the equivalent of a 21-weeker when I was born. My parents were told I had about a 5% chance of surviving, but I had a different plan. After 159 days (over 5 months) in the NICU at Georgetown University Hospital, I came home. During my stay at the NICU I endured many of the obstacles that are presented to micro preemies like me. I was on the ventilator for 2 months and as a result I suffer from chronic lung disease (CLD/BPD), but that doesn t bother me too much now. I had heart surgery at one week old to close my PDA (Patent Ductus Arteriosis). My parents were really nervous that day. I had multiple blood and platelet transfusions during my first two months of life. I had some brain bleeds that have resulted in slight Cerebral Palsy on the left side of my body, but it doesn t slow me down. I developed Stage 3+ ROP (Retinopathy of Prematurity) in my eyes, which was corrected with laser surgery. As a result, I get to wear these really cool glasses and everyone says I look so cute in them. My favorite time when I was in the NICU was everyday when my parents came to visit. I came home on oxygen, an NG tube, an apnea monitor, a pulse ox monitor, neb treatments 4 times a day, and on 10 different medications. My house looked like a hospital and I had 16 hour a day nursing care for the first year. For the first several months at home I was fed continuously through my NG tube via a pump due to risk of aspiration (getting fluid in my lungs). I hated having that tube stuck down my nose into my tummy and was always trying to pull it out. I finally got rid of the NG tube at 9 months of age and the oxygen at 20 months of age. In summer 2005, I underwent spinal surgery to correct a tethered spinal cord (TCS) and will need follow-up MRI s periodically to make sure it does not re-tether. Today I m 7 years old and I weigh 42 pounds. I still go to speech, physical, and occupational therapy on a weekly basis and all my therapists are so pleased with my progress. I love to practice for physical therapy on my play set that I got for my 6th birthday. It is so much fun to climb the rock wall, swing, and slide down the big yellow slide. I m in kindergarten this year and I get to ride the bus to school everyday. My parents are so proud of my progress. You would never know that I didn t walk until I was 3 or talk until I was 4. They refer to me as their million-dollar miracle. I have no idea how much a million dollars is, but I think I might be close to getting a million dollars because the tooth fairy keeps bringing me money for losing my teeth! I m so happy my parents have taken such an interest in helping prematurity related causes such as the Georgetown University NICU/Pediatrics and the March of Dimes. I spent my first 159 days of life in the NICU and I am forever grateful to all the nurses and doctors who saved my life and took such good care of me while I was there. I want to make sure they can continue saving babies like me for years to come. I also spent time in the Georgetown University Hospital Pediatric ICU in 2005 after my spinal surgery. The March of Dimes has launched a national campaign to raise money for prematurity research to help other babies like me. I am alive today because they funded research that resulted in the development of surfactant, a substance that helped my immature lungs to breathe. They even invited me to be the 2009 National Ambassador for the March of Dimes and I spent the year traveling the country sharing my story and helping in the fight against prematurity. I would love for you to come and join me, my parents, friends, and other supporters and play in Team Katelyn s 6th Annual Golf Tournament to raise money for these causes so other babies and families can have the same opportunities that we were given. I will be there and am looking forward to seeing you there.
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