Rocky Mountain Diving Club Registration - Family Fun
Seton YMCA
4995 Market St SE, Calgary, AB AB T3M 2P9

Class time:
Every Saturdays
From May 11- Jun 29

Name *
Your answer
Address *
Your answer
E-mail *
Your answer
Emergency Contact (Name) *
Your answer
Emergency Phone *
Your answer
Physical restrictions, recent injuries or illnesses, allergies, etc. of which Rocky Mountain Diving Club should be aware:
Your answer
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. *
How many adults? *
Please indicate name and date of birth *
Your answer
How many children will be coming with you? *
Please indicate name and date of birth *
Your answer
Adult: $20/person (pool admission fee included)
Children: $10/person (pool admission fee included)
Payment *
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

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
Credit Card #
Your answer
Expiry Date
Your answer
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service