REGISTRATION

Personal Information

Full Name of Applicant

Full Name of Child (if registering on behalf of them)

Applicant Date of Birth

Address

Street Address Address Line 2 City Province Postal Code

Phone Number

Email Address

Program-Specific Information

Program Name

Session Dates/Times

Time

Program Location

Previous Experience

Special Requirements

Consent to Photo

Yes

By checking the "Yes" box, you consent to the use of photos or videos taken during the program/event.

Emergency Contact Information

Emergency Contact Name

Relationship to Participant

Emergency Contact Phone Number

Alternative Emergency Contact

Medical Information (if applicable)

Allergies

Current Medications

Medical Conditions

Payment Information

Registration Option

Kids in the Kitchen St Malo ( Drop-in ) $65

Coupon

Total

Payment Method*

E-transfer

E-Transfer to occur upon submission of the registration form. E-transfer can be sent to info@ratriverrecreation.com. Payment must be sent before successfully being registered.

Payment*

Confirmation

Signature*

Date*

Comments

This field is for validation purposes and should be left unchanged.

RECREATION

PARKS & FACILITIES

NEWS & BLOGS

GALLERY

VOLUNTEER