YES!  I will be participating in the Golf FORE Healthcare Tournament on:

My preferred tee-time is:

Are you registering as part of a team during the Golf FORE Healthcare Tournament?

If you are registering as part of a team, please list your teammates. (Maximum of 5 players per team).

Is your team sponsored?  If so, by who:

My $100 Registration Fee:

I would like my donation directed towards:

First name:

Last name:

Business Name (If Applicable)

Mailing Address:

Email:

Phone number:

RELEASE, WAIVER AND INDEMNITY

By selecting "I ACCEPT" below, I hereby state that I am of reasonable fitness to participate in the Golf FORE Healthcare Tournament, furthermore referred to as "The Tournament".  I understand that there is no supervision for The Tournament.  I am participating in The Tournament of my own free will.  I fully understand the risks and benefits and accept all consequences as a result of my participation.  I hereby hold harmless, waive and release Eastern Health and its employees, agents, organizers, representatives and volunteers of Eastern Health from any liability, responsibility, demands or claims of any kind arising out of my participation in The Tournament.  By selecting "I ACCEPT", I hereby indicate that I have read and understand this Disclaimer of Liability.  I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.