embers golf tournament 2013 - player registration

7/30/2019 Embers Golf Tournament 2013 - Player Registration

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7/30/2019 Embers Golf Tournament 2013 - Player Registration

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7/30/2019 Embers Golf Tournament 2013 - Player Registration

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7/30/2019 Embers Golf Tournament 2013 - Player Registration

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Please email or fax this completed form toCassie Dixon | cassie@embersvancouver.com

Phone: 604 692 0781Fax: 604 692 0780

Payment due July 1st, 2please make cheques payable to Em

player #1name companyaddress city

postal code phone

fax email

charge to [ ] visa [ ] mastercard # expiry

signature [ ] pay for team [ ] individual only

player #2name company

address city

postal code phone

fax email

charge to [ ] visa [ ] mastercard # expiry

signature [ ] pay for team [ ] individual only

player #3name company

address city

postal code phone

fax email

charge to [ ] visa [ ] mastercard # expiry

signature [ ] pay for team [ ] individual only

player #4name company

address city

postal code phone

fax email

charge to [ ] visa [ ] mastercard # expiry

signature [ ] pay for team [ ] individual only