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21st Annual Golf For A Cure


Golden Eagle Golf Club
"North & South Courses"
21770 Ladner Rd
Pitt Meadows, BC
Tel: 604-460-1111
www.goldeneaglegolfclub.com

The 21st Golf For A Cure will be held at Golden Eagles Golf Club. For the first time this event will be expanding it’s number of golfers filling both the North & South courses and we are so excited to host more amazing childhood cancer supporters.

All donations are drawn in Canadian funds.

Sponsorship

I will support the Tournament with a sponsorship selected below: *

Platinum level - $10,000.00

Diamond level - $5,000.00

Gold level - $3,500.00

Silver level - $2,000.00

Cart Sponsorship level - $1,600.00

Hole Sponsorship level - $500.00

Not Applicable level - $0.00

If you would like to pay offline, please print out our Sponsorship Registration Form.

Registration Option

$175.00 Please register me as an individual golfer. My payment is enclosed

$700.00 We have a four-person team arranged and they are listed below. The team payment is enclosed

I cannot play this year


Donation

I would be pleased to donate the following amount.

$



Payment Information

I will pay with:
Credit Card     OR   
Cheque or Money Order

If paying with Credit Card:


If paying with Cheque/Money Order:

Please send your payment to:

Michael Cuccione Foundation
P.O. Box 31081,
8-2929 St. Johns Street
Port Moody, BC V3H 4T4

If you have any questions, please call us Toll Free at 1 866 860 CURE (2873) in North America or 604-552-2850 local British Columbia.




Players Information

Team Contact or Individual


Confirmation will be sent via email.

2nd Player



3rd Player


4th Player





Optional

Would you like us to contact you from time to time to advise of upcoming events?
Yes   No

Are you interested in volunteering at an upcoming event?
Yes   No

Additional Comments: If you are registering to any particular event, or donating with specific condition (i.e. donating to enter your name to a win a jersey draw, etc.) please enter your notes below.

Do you require a tax receipt?
No Yes
If your donation is $25.00 or more, what name or organization do you want to appear on the tax receipt?