Rocky Mountain Diving Club Registration - Summer Day Camp
Location:
Seton YMCA
4995 Market St SE, Calgary, AB AB T3M 2P9
Name *
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Address *
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Date of Birth *
MM
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DD
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YYYY
Age *
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Gender *
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E-mail *
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Emergency Contact (Name) *
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Emergency Phone *
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Other Current Sporting Activities
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Physical restrictions, recent injuries or illnesses, allergies, etc. of which Rocky Mountain Diving Club should be aware:
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Previous RMDC dive session registered in (if any): *
If yes, what level?
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How did you first find out about Rocky Mountain Diving Club?
I/We being the parent(s)/guardian(s) of the child of the City of Calgary, in the Province of Alberta, do hereby grant permission for the said child to participate in club activities under the general supervision of Rocky Mountain Diving Club, their coaches, officials or supervisors. It is agreed that these activities may occur any time during the calendar year. I/We do hereby consent to any emergency medical attention or any other emergency care or treatment considered by coach designated manager, or other designated responsible adult. *
Required
Camp that you are registering in *
Required
Early Bird Discount
We will be apply early bird discount based on the date you signed up
Registered on March - 20% off
Registered on April - 10% off
Registered on May - 5% off
Payment *
Required
If you choose: Cash OR Cheque
Please pay directly to Program Coordinator ON THE FIRST DAY OF CLASS or Mail to Rocky Mountain Diving Club Mailbox

Payable to: Rocky Mountain Diving Club

ADDRESS
Rocky Mountain Diving Club
2225 Macleod Trail South, AB
T2G 5B6

If you choose: VISA OR Master Card
Please indicate your Credit Card # , Expiry Date (mm/yy) , Amount below
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Expiry Date
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Amount
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