Registration for the school year 2020-21.

Student Details (*) indicates required field

School Student Number:
Grade:
School Name:

Are you a Returning Member?
First name:
Last name:

Home phone:
Cell phone:
Email address:

Street Address:
Unit#/Appt:
City:

Postal:
DoB:
Languages:

Other Team?:
Other Team Number:
Other Team Exists?:




Health Information (*) indicates required field


Emergency Contact:
Last Name:
Phone:

Relation:
Health Card Number:

Doctors Name:
Doctors Phone:

Do you have any allergies?:
Allergy Description:

Do you carry Medical bracelet?:
Medical Tag Description:

Do you take Medications?:
Medication Description:

Do you use Epipen?:
Do you use Inhaler?:

Food Restrictions:
Other Notes:




Parent Information (*) indicates required field


Parent first name:
Last Name:
Address same as student?:

Street Address:
Unit#/Appt:
City:

Postal:
Workphone:
Extension:

Homephone:
Cell phone:
Email:

Relation to student:
Skills: