Annual Golf Classic Registration Form - Dartmouth General Hospital Foundation

Entry Name(Required)

Entry Type(Required)

Team (4 players)

Individual entry

Individual Entry(Required)

Price:

Team Entry(Required)

Price:

Payment Method(Required)

Cheque

Credit Card

Invoice

Once we have received your registration request, we will contact you by phone to process your payment. We will do so within 1 business day.

Make your check payable to DGH Foundation, and mail it to 325 Pleasant Street, Dartmouth NS B2Y 4G8.

The invoice will be sent via email to the captain's email address.

Captain's Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Shirt Size(Required)

Player 2 Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Shirt Size(Required)

Player 3 Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Shirt Size(Required)

Player 4 Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Shirt Size(Required)