BYSREG#2

"BUILD YOUR SKILLS" REGISTRATION FOR TWO

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PARTICIPANT #1 INFORMATION:

* Indicates required field

Participant #1 Full Name *

First

Last

D.O.B (yyyy/mm/dd) *

Grade *

Name of school currently attending *

Height (in ft.) *

T-shirt size *

PARTICIPANT #2 INFORMATION:

Participant #2 Full Name *

First

Last

D.O.B (yyyy/mm/dd) *

Grade *

Name of school currently attending *

Height (in ft.) *

T-shirt size *

PARENT INFORMATION:

Phone Number *

Parent Name: *

Parent Email *

Street Address *

Apt#/Suite# *

City *

Province *

Postal Code *

EMERGENCY INFORMATION:

Emergency Contact Name *

First

Last

State relationship *

Phone Number *

Please specify any medical conditions: *

If your daughter has any allergies, she must be equipped with an epi-pen at all times.
If your daughter is asthmatic, she must be equipped with a puffer at all times.
Failure to meet these safety conditions will result in the removal of your daughter's participation for that day. NO REFUNDS.

PAYMENT INFORMATION:

Please select method of payment: *

**Please note a cancellation fee of $40 per transaction will be withheld.

SUBMIT