OPIA Golf Classic Registration Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Organization(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code Country

1st Golfer

2nd Golfer

3rd Golfer

4th Golfer

Select An Option

4 Golfers (OPIA Member) $1,100.00 CAD

1 Golfer (OPIA Member) $275.00 CAD

4 Golfers (Non-Member) $1,350.00 CAD

1 Golfer (Non-Member) $350.00 CAD

Subtotal

$ 0.00 CAD

HST

$ 0.00 CAD

Total

Credit Card

Card Details

Cardholder Name

Comments

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Register for the OPIA Golf Classic