Complete Mailing Address (#, Street, city, prov, postal code) *
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Parent/Guardian Name (First and Last) *
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Relationship to Student *
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Father
Mother
Grandparent
Guardian
Other
Emergency Contact OTHER THAN PARENT (name & phone) *
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Which program(s) is this student trying for free? OR Training in (Check all that may apply) *
Required
Medical/ Physical Info Pertinent to Training (Asthma, Hemophilia, allergies, ADHD, Autism, Palsy, previous injuries, previous surgeries, etc. OR N/A) *
Your answer
How did you hear about YMATC? (Social media, refer a friend, etc) *