Kenora Borealis 2019 FALL  Swimming Registration
Session Dates: Tuesday September 17 - Thursday December 19
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Last Name *
First Name *
Mailing Address *
Emergency Contact *
Date of Birth *
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Home Phone Number *
Cell Phone Number *
Email address *
Known Medical Conditions, please indicate if you are carrying medications with you while attending swimming. *
Kenora Borealis Masters Affiliation Fees. Fees covers Insurance, Liability, Meter Tracking. *
Required
Session Fees - payments method: Cheques made payable to Kenora Borealis, or e transfer kenoraborealis@gmail.com  *
Required
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