Burnaby Bears Field Hockey Club - 2019 Winter Learn 2 Field Hockey Registration

Our Learn 2 Train program is six sessions, running on Saturday afternoons from February 2nd to March 9th from 1:30 to 3:00pm.

Eligible athletes must be born in 2006 or younger. All Elementary School ages welcome.

Registration Information
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian 1 *
Your answer
Parent/Guardian 2
Your answer
Email 1 *
Your answer
Email 2
Your answer
Email 3
Your answer
Phone Number 1 *
Your answer
Phone Number 2
Your answer
Suite
Your answer
Home Address *
Your answer
Postal Code *
Your answer
City *
Province *
Work Address (answer if you work in Burnaby, but do not live in Burnaby)
Your answer
Emergency Information
Medical Concerns (enter None of no concerns) *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Field Hockey BC Membership (mandatory)
Register with Field Hockey BC to get your Membership Number before you complete this registration:

https://www.fieldhockeybc.ca/fhbc/membership.php

Field Hockey BC Membership Number *
Your answer
Photo Release
Permission to use athlete photograph for Club Website, Social Media, Promotions *
Registration Payment Information
Registraion is $50 due February 2nd


Mail your registration cheque to:

Burnaby Bears Field Hockey Club
5582 Forglen Drive
Burnaby, BC
V5H 3L1

Etransfer your payment to:

bbybearstreasurer@gmail.com
Lauren Pughe - BBFHC Treasurer
Q: What sport are we learning?
A: field hockey

How did you hear about us? *
Your answer
Contact Us
Email: burnabybears@gmail.com

Website: https://www.burnabybearsfieldhockey.com

Facebook: https://www.facebook.com/burnabybearsfhc

Instagram: burnabybearsfhc Twitter: burnabybearsfhc Snapchat: burnabybearsfhc

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service