PDBC 2017 Registration Form
Registration Form for Academy, BMO, Competitive and Youth programs
* Required
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Street Address
*
Your answer
Gender
*
Female
Male
Emergency Contact Name
*
Your answer
Emergency Contact Number
*
Your answer
Which program are you registering for?
*
Local Full Membership (Competitive Only)
Local Summer Membership (Competitive Only)
Distance Full Membership (Competitive Only)
Distance Summer Membership (Competitive Only)
Academy Membership
Youth Membership (Junior & U24)
BMO
Paddling Side
*
Left
Right
Both
Unknown (Beginner)
Paddling Division Based on Age (Competitive Registrants Only)
Junior (14-17)
U24 (18-23)
Premier
Senior B
Senior C
Desired Academy Program (Academy Registrants Only)
Beginner/Novice (Abbey)
Beginner/Novice (Amy ) July- August
Intermediate/Advanced (Kat/Matt)
Regatta Attendance (Please check off all regattas you will be attending)
*
Pickering June 3/4
Montreal July 8/9
Guelph July 29
Canadian Championships August 4/5/6 (Competitive Only)
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Additional Terms
Forms