Team Registration Form for 2012

Please complete as much as possible. Team registration fee total is $1084.00 and includes raffle tickets ($650.00 entry fee + $434.00 for 13 books of raffle tickets prepaid).

Please note that the tax receipting process for 2012 is the same as last year... this is to ensure that the Crohn’s and Colitis Foundation of Canada remains in compliance with Canada Revenue Agency. A portion of the $650 registration fee is be tax receiptable as opposed to the full registration fee amount.
The raffle tickets are not tax receiptable. CCFC sincerely appreciates your understanding in this matter and thanks you for your support of Guts'n Pucks. We look forward to yet another exciting and successful event!
Crohns & Colitis Foundation of Canada

* Indicates a required field to enrol your team.

*Team Name:
*Sponsor(s):
*Captain:
Company:
*Address:
Address:
*Town/City:
*Province/State:
*Postal/Zip Code:
*Email:
*Phone:
Fax:
Cell:
Asst. Captain:
Company:
Address:
Address:
Town/City:
Province/State:
Postal/Zip Code:
Email:
Phone:
Fax:
Cell:
*Requested Division:
*Sweater Colours:
	Alternate set of sweaters available? Yes No
If Yes, Colours?
*Entry Fee Method of Payment:	Cheque Call Penny Weir 519-802-2156 pweir@ccfc.ca to pay by credit card. Please reference the Guts'n Pucks and your team name. Make cheques payable to the CCFC (Crohn's and Colitis Foundation of Canada) Please send the cheques to: Penny Weir Crohn's and Colitis Foundation of Canada 60 St. Clair Avenue East Suite #600 Toronto, ON M4T 1N5
	Charitable Receipt Required? Yes No
If yes - Name and Address:
	Raffle tickets shipped upon receipt of fee to Captain? Yes No
If no above indicate address or alternative arrangements:
	Women's change room required? Yes No
Comments, Ideas or Special requests box: