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Registration Form

Please have your registration submitted by Wednesday, July 12th, 2017.  Payment must accompany form to be registered. No refunds after August 17th. 

Please fill out editable registration form below and email to foundation@bgh-on.ca

If you are paying by cheque, please submit form and payment to: Brockville & District Hospital Foundation Office, 75 Charles Street, Brockville, Ontario K6V 1S8

Please note: The Friends of Palliative Care golf tournament will be photographed and/or filmed and images could be used in Friends of Palliative Care golf publications and website as well as the Brockville General Hospital and/or Foundation newsletters and websites.  By participating in this event, you agree to this.

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Tee of Preference (Please make sure your group is registered and PAID IN FULL in order to guarantee your spot.)*
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Player #2
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•  FAST FACTS  •

Fast Fact

28 Years The Tournament Has Been Running

Fast Fact

10 PC Beds in the New Donald B. Green Tower

Fast Fact

Over 3,800,00 Raised in 27 Years.

Fast Fact

Over 290 New People Were Referred in 2020