Smashball Registration

Dates: Jan 22 – April 1st (10 sessions, no session during spring break – March 18th)
Day: Wednesday
Grades 3 & 4 – 4:00-5:15
Grades 5 & 6 – 5:15 – 6:30
Location: Robron Center
Boys & Girls welcome
Cost: $120

Athlete Information

First Name (Required):
Last Name (Required):
Birthdate (Required):
Cell Phone:
Email:
Care Card Number (Required):
T-Shirt Size:
Medical Concerns, Allergies, Previous Injuries:

Guardian #1

First Name (Required):
Last Name (Required):
Address (Required):
City (Required):
Postal Code (Required):
Home Phone:
Cell Phone:
Email Address (Required):

Guardian #2

(only complete address/phone information if different than above)
First Name:
Last Name:
Address:
City:
Postal Code:
Home Phone:
Cell Phone:
Email Address:

Emergency Contact (other than above)

First Name:
Last Name:
Home Phone:
Relationship to Athlete:

By checking the box above I, the parent/guardian of the above participant, agree the terms set out in this consent form.

Once you submit this form you will redirected to PayPal to to pay the $120 registration fee. If you would prefer to pay via an e-transfer, cash, or cheque please just close the window once you have submitted this form and email treasurer@crushvb.ca