TEAM NAME:

______________________________________________

Division Open ___ Family _____

Team Members

Team Captain:

1. _________________________________________

2. _________________________________________

3. _________________________________________

4. _________________________________________

5. _________________________________________

6. _________________________________________

(open div only)

Team Contact Name:

Street Address:

Apt No:

City:

Prov:

Postal:

Email:

Phone No:

Payment Method: Cheque  Cash  MC  Visa 

For MC or Visa, card number may be phoned in or paid in person at the Tabusintac Chalets Incorporated at 506-779-8222.