Kenora Borealis 2019 FALL Swimming Registration
Session Dates: Tuesday September 17 - Thursday December 19
Last Name *
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First Name *
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Mailing Address *
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Emergency Contact *
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Date of Birth *
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Home Phone Number *
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Cell Phone Number *
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Email address *
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Known Medical Conditions, please indicate if you are carrying medications with you while attending swimming. *
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Kenora Borealis Masters Affiliation Fees. Fees covers Insurance, Liability, Meter Tracking. *
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Session Fees - payments method: Cheques made payable to Kenora Borealis, or e transfer kenoraborealis@gmail.com *
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