Registration Form
 
Athlete ID Number
1. General Information
First Name: Last Name:
Address: Postal Code:
City: Home Phone:
E-mail:
Birthdate:
 
MHSC # PHIN
Male Female
Please list any medical concerns (asthma, injuries, etc..)
 
School:
Grade:
T-Shirt Size: Youth Small Youth Med Youth Lge Adult Small Adult Med Adult Lge
 
2. Parent/Guardian Information
Father:Mother:
First Name: First Name:
Last Name: Last Name:
Home Phone: Home Phone:
Work/Cel Phone: Work/Cel Phone:
Employer: Employer:
   
   
COST OF PROGRAM: $110.00

Mail cheques payable to:

Winman Volleyball Club
54 McMullen Cr.
Winnipeg, MB
R2C 3W9