Company Name:

Contact Name

Address:

City:

Province:

Postal Code:

Email:

Phone:

Fax:

Name of Gofler(s)

Number of Golfers:

at $175 each =

or Corporate Team at $900 

Tax receipts will be issued for the charitable porton of the entry fee (approximately $75)

Please Invoice Company:          Paying Online:

Tax Receipt for Company:           Tax Receipt for Individuals:      No Tax Receipt Required: