Fire Dawgs Fitness Registration 2019 (Girls Only)

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Date: October 21st to December 9th, 2019
Time: 3:15pm to 4:15pm
Day: Monday's
Age: Grade 7 to 10

Email *

First Name (Child) *

Last Name (Child): *

School Grade of Child: *

Grade 7-10 (Ages 12-15) (3:30-4:30pm)

Required

First Name (Parent/Guardian): *

Last Name (Parent/Guardian): *

Phone (H) (Parent/Guardian) (ie. 613-267-5574): *

Phone (C) (Parent/Guardian) (ie. 613-267-5574):

Email (Parent/Guardian): *

Medical Concerns: *

Please provide details of medical concerns (Allergies or Medical Conditions):

Please read carefully: I agree that the Perth Fire Fighters Association will not be held Responsible for any accidents, injury or loss of personal property, however caused, and agree to release Perth Fire Fighters Association from any claims or damages which may arise as a result of such accident or injury.

I have read the foregoing and agree to the terms and conditions and certify that I am the player's parent or legal guardian.

A copy of your responses will be emailed to the address you provided.

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