FAX: 905 427-4050
2011 Michael / Bryan Golf Tournament
Pre-Registration Form

Team Name:_________________________________________________________

Player 1:__________________________________________________________

Email Address:_____________________________________________________


Player 2:__________________________________________________________

Email Address:_____________________________________________________


Player 3:__________________________________________________________

Email Address:_____________________________________________________


Player 4:__________________________________________________________

Email Address:_____________________________________________________


Individual Player Registration:

Player:___________________________________ Phone (            )______________

Email Address:______________________________________________________

Form of Payment:  $150.00 each $600 Team    (circle one)     Cheque       Cash       Credit Card
        Payable to Michael Bryan OPEN
Credit Card:    (circle one)     Visa       M/C

Number:  __ __ __ __     __ __ __ __     __ __ __ __     __ __ __ __     Exp. Date ___/____

Name on Card:____________________________________________________