Gold in the Net Golf Classic Registration Form

Saturday May 1, 2021 "Eaglecrest Golf Club" Qualicum BC Shot Gun Start 1:30 PM (To Be Confirmed)

First Name *

Last Name *

Street Address

City

Prov.

Postal Code

Phone Number *

Email Address *

Golf Groups

Team Name

Golfer Name #1

Golf & Dinner $125

Golfer Name #2

Golf & Dinner $125

Golfer Name #3

Golf & Dinner $125

Golfer Name #4

Golf & Dinner $125

Dinner Only

Dinner Guest 1

Dinner $35

Dinner Guest 2

Dinner $35

Dinner Guest 3

Dinner $35

Dinner Guest 4

Dinner $35

Dinner Guest 5

Dinner $35

Dinner Guest 6

Dinner $35

Dinner/Auction Table Request

Table Reservation

10 Guests (full table)

8 Guests

4 Guests

Reservation Name:

Donations & Auction Items & Hole Sponsors

Silent Auction Item	Cash Donation $50	Cash Donation $100
Hole Sponsor $150

The Hole Sponsor Sign will be place on hole number of Sponsors choice (providing available) and also displayed after at clubhouse. Please send your logo and contact information to Debbie at gold@goldinthenet.com

Donation Name and Notes

Payment Information

Total Amount *

Cheque

Cash

Credit Card

E-Transfer

Name on Card

Credit Card Type

Credit Card Number

CVV (3 Digits Back of Card)

Expiration Date (mm/yy)

Billing Postal or Zip Code

Enter the word in the box *
captcha

Cheque's by Mail:

Gold in the Net Bursary Fund

P.O. Box 414, Lantzville BC V0R 2H0

E-Transfer: Contact gold@goldinthenet.com 250-586-4342

to arrange e-transfer.