Sackawa Canoe Club | June 27, 2015
Sponsored by:
Registration Form
Register by email to [email protected] prior to June 20th to reserve your spot. Completed form
and $40 payment required at registration the morning of the event in order to participate.
Team Name
Team Contact Information
Player #1
Last Name
First Name
Street Address
E-mail Address
Business Phone
Cell Phone
Emergency #
Player #2
Last Name
First Name
Street Address
E-mail Address
Business Phone
Cell Phone
Emergency #
Payment
Each team entry is $40. Payment is due in full at registration on June 27th.
Payment by credit card
Mastercard
YES
NO
Visa
Card Number
Expiry
Name on Card
Invoice Required YES
Payment by cheque
YES
NO
Prizing and Auction Support
Security Code
NO
please make cheque payable to Sackawa Canoe Club
Please contact me to discuss prizing and/or auction support
YES
NO
Contact Lynnann at [email protected] by no later than June 20, 2015 if you plan to participate or for more
information.