IHM Golf Tournament Registration

Contact Information

Title:
First name: *
Last name: *
Organization: *
Address: *
City: *
Province: *
Postal Code: *
Country: *
Phone: *
Fax:
E-mail:

Golf Registration Type *

Player Information

Player 1
First Name *		Last Name *		Company		Email *
Player 2
First Name *		Last Name *		Company		Email *
Player 3
First Name *		Last Name *		Company		Email *
Player 4
First Name *		Last Name *		Company		Email *
Player 5
First Name *		Last Name *		Company		Email *
Player 6
First Name *		Last Name *		Company		Email *
Player 7
First Name *		Last Name *		Company		Email *
Player 8
First Name *		Last Name *		Company		Email *

Payment Information

Subtotal:	0.00
Tax (13% HST):	0.00
Total:	0.00
Payment Method:
Cheque Name:
Cheque Number:
Financial Institution:
Name on Card: *
Credit Card Number: *
CVC: *
Expiration (MM/YYYY): *	/

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