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