PaPreg2

"PARENTS AT PLAY" FOR TWO REGISTRATION

* Indicates required field

Select Winter Program Your Daughter is in: *

Parent #1 Full Name *

First

Last

Are you aged 25 years or older? *

T-shirt size #1 (unisex) *

Parent #2 Full Name *

First

Last

Are you aged 25 years or older? *

T-shirt size #2 (unisex) *

Phone Number *

Email *

Instagram handle *

City *

Province *

Postal Code *

EMERGENCY INFORMATION:

Emergency Contact Name *

First

Last

State relationship *

Phone Number *

Please specify any medical conditions: *

PAYMENT INFORMATION:

Please bring exact cash if you are dropping in. $10 per person. Otherwise you can pay a one-time fee of $80 for the 8 weeks for two people..

SUBMIT