Participant Application Form:
If you are 14 - 18 and would like to attend please fill out the form below.
Required Fields
*
Name:
*
Sex:
*
Male
Female
Email:
*
Address:
*
City:
*
Province:
*
Postal Code:
*
Phone:
*
Fax:
School Name:
*
Medicare # and Any health problems (including allergies/food sensitivities):
*
Date of Birth (month/day/year):
*
T-Shirt Size:
*
small
medium
large
XLarge
XXLarge
I am sponsored by:
*
my parents
, Contact name:
*
co-operative
, Name, Contact name and phone number:
*
credit union
, Name:
, Contact name and phone number:
*
caisse populaire
, Name:
, Contact name and phone number:
*
other
, Contact name and phone number:
*
Name and location of seminar you want to attend:
*