Peter Saracino Alzheimer Golf Classic: Registration Form
Please provide us with the info below so we can properly recognize your golfing party. The deadline to register as a golfer is August 26, 2025. All payments are due by September 2, 2025.
Price per ticket:
CAD $250
Number of tickets
Please Select
1
2
3
4
Grand Total ($)
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Purchaser Information
Organization
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a preference for who you would like to be paired with?
What is your preferred tee time (we will do our best but not guaranteed!)
AM
PM
E-Mail List
Yes, add me to your e-mail list so I can receive news and updates from Alzheimer Society Niagara Foundation
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Attendee Information
Golfer 1
Name
*
First Name
Last Name
Organization
Email
example@example.com
Do you require special services for mobility challenges or dietary requirements?
*
Please select your dinner option of choice
*
Please Select
Chicken
Roast Beef
Golfer 2
Name
*
First Name
Last Name
Organization
Email
example@example.com
Do you require special services for mobility challenges or dietary requirements?
Please select your dinner option of choice
Please Select
Chicken
Roast Beef
Golfer 3
Name
*
First Name
Last Name
Organization
Email
example@example.com
Do you require special services for mobility challenges or dietary requirements?
Please select your dinner option of choice
Please Select
Chicken
Roast Beef
Golfer 4
Name
*
First Name
Last Name
Organization
Email
example@example.com
Do you require special services for mobility challenges or dietary requirements?
Please select your dinner option of choice
Please Select
Chicken
Roast Beef
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Payment Options
*
Please Select
Cheque
E-transfer
Credit Card through PayPal (Online)
Credit Card over the phone (Offline)
You will receive an email with additional instructions based on your selection.
Payment Amount
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( X )
CAD
Description
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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