Welcome to the registration for Kintec's Annual Family Physicians Golf Tournament!

WAITLIST:

Our Golf Tournament on Thursday, June 23, 2022 is sold out! Thanks again to everyone who registered. If you’re still interested in playing, our waitlist registration is still open. Please express your interest to play by registering below, as we usually have a few cancellations leading up to the event.
Individual Registration
Event:  *
Event Date:  *
First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Address:  *
City:  *
Province:
Country:
Postal/ZIP Code:
Which EMR system does your clinic use?
If other, please specify:
Notes:

Fields marked with * are required
Pair Registration

Team Leader

Event:  *
Event Date:  *
First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Address:  *
City:  *
Province:
Country:
Postal/ZIP Code:
Which EMR system does your clinic use?
If other, please specify:

Other Participant

First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Job Title:  *
If other, please specify:
Clinic Name:
Notes:

Fields marked with * are required
Foursome Registration

Team Leader

Event:  *
Event Date:  *
First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Address:  *
City:  *
Province:
Country:
Postal/ZIP Code:
Which EMR system does your clinic use?
If other, please specify:

Please register your other 3 participants below

First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Job Title:  *
If other, please specify:
Clinic Name:
First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Job Title:  *
If other, please specify:
Clinic Name:
First Name:  *
Last Name:  *
Email Address:  *
Telephone:
Fax:
Job Title:  *
If other, please specify:
Clinic Name:
Notes:

Fields marked with * are required

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