Seminars | Golf Tournament | Car Raffle | Clean Up

For more information contact the Coping Centre (see below)

Please provide the following information:

Name:
Street Address:
Address (cont.)
City:
State/Province:
Zip/Postal Code:
Work Phone:
Home Phone:
E-mail:

 

Names of Players attending:

 

Payment:

Golf, Cart & Dinner Combo		(Note: A charitable donation receipt will be issued for $85)
$165 x = $
Additional Dinner		(must be reserved in advance for catering purposes)
$ 38 x = $
Hole Sponsorship
$250 x = $
	Total $
Payment is due upon arrival at the tournament and can be paid by Cheque, Visa or Mastercard.

 

In addition, I would like to contribute:

An auction item:
A golf prize:

 

 

We look forward to seeing you!
If you have any questions, please contact us:

COPING CENTRE
1-877-554-4498 or 519-650-0852
Fax: 519-650-1949
Email: coping@copingcentre.com