Kenora Borealis Multisport Membership Form
Want to join our club? This is our Membership Application due annually in September
Last Name *
First Name *
Mailing Address *
Email address *
Date of Birth *
MM
/
DD
/
YYYY
Contact Number (please include area code) *
Emergency Contact Person *
Emergency Contact Number (please include area code) *
Medical History/Allergies/Medications
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