2018 Cobra Team Sign Up 2018 Cobra Team Sign Up Please enable JavaScript in your browser to complete this form.Name:Email:Subject:Message:NAME OF PROGRAM YOU ARE REGISTERING FOR[Select One]OPTION #1 (No Membership)OPTION #2 (Membership)OPTION #3PLAYERS NAMESHIRT SIZEYouthLadiesMen'su3000SmMedLgXLgDO YOU HAVE YOUR OWN GOLF CLUBSYesNoDO YOU SWINGRightLeftADDRESSCITY/ PROVINCEPOSTAL CODEBIRTH DATEAGEPLAYERS PHONE NUMBER(S)PARENTS NAME(S)PARENTS PHONEPLAYERS E-MAILEMERGENCY CONTACT (if different than above)PHONE #PROVINCIAL HEALTH CARD #PLEASE LIST ANY AND ALL MEDICAL CONDITIONS AND ALLERGIES (If None, put N/A)METHOD OF PAYMENTCREDIT CARDCASHTYPEMCVISACREDIT CARD NUMBEREXPIRATION DATETOTAL CHARGED $AgreeChoice 0DATED atPrint Name of Parent /GuardianWebsiteSubmit
