Engage Youth Registration

Student Information

Student Name

Student Cell (If applicable)

Student Email (if applicable)

This address will receive a confirmation email

Address

Birthdate

Health Card #

Parent / Guardian Information

Parent / Guardian Name

Parent / Guardian Phone Number

Parent / Guardian Email address

This address will receive a confirmation email

Would you like to subscribe to our parents newsletter?

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Additional Information

Medical conditions or Items of note

Description

Please fill out this form so that we can ensure the safety of our students and to keep all the families up to date on events and cancellations if necessary!

Engage Youth Registration

Description

Please Fix the Following