REGISTRATION AND PAYMENT DUE BY JUNE 1, 2019

CONTACT NAME (FIRST LAST) *

COMPANY NAME

Street Address *

Address Line 2

CITY, PROVINCE *

POSTAL CODE *

TEL NUMBER *

EMAIL ADDRESS *

GOLF & DINNER OPTIONS

SPONSORSHIP OPTIONS

Golfer #1 (FULL NAME)

Golfer #2 (FULL NAME)

Golfer #3 (FULL NAME)

Golfer #4 (FULL NAME)

Additional golfer names (for more than 1 foursome):

Please make cheques payable to:

DINEEN CONSTRUCTION (2017) CORPORATION

70 Disco Road, Suite 300 Toronto ON M9W1L9