Name *

First Name

Last Name

Athletes Name

If you are filling out the form on behalf of your child please fill out their name here

First Name

Last Name

Date of Birth *

If you are filling out the form on behalf of your child please enter their Date of Birth

MM

DD

YYYY

By checking the box I have read the Contract, Waiver & PAR-Q

A link to the Contract, Waiver & PAR-Q can be found at the bottom of the page

I Agree to the Contract

I Agree to the Waiver

I Agree to the PAR-Q

Date

MM

DD

YYYY