Online Registration Form for 2023 ATHLETICS NIAGARA

2023 ATHLETICS NIAGARA

Ridgeway, Ontario
Membership Year: 2023

Deadline: Dec 31 at 23:59 (Eastern Time)

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Athletics Ontario # * Look up
* Athletes must be signed up through Athletics Ontario each year before completing this form.
Click here to register with Athletics Ontario.

First Name *

Last Name *

Gender *

Male Female

DOB (YYYY/MM/DD) *

/ /

Citizenship *

Birth Country *

Email *

Address *

City *

Province *

Country *

Postal Code *

Phone

Emergency Contact Name *

Contact Relationship *

Contact Email *

Contact Phone *

Allergies or health concerns

Cell Phone

School Name

Track Interest

Parent/Guardian Name #1

Parent/Guardian Cell #1

Parent/Guardian Email #1

Parent/Guardian Name #2

Parent/Guardian Cell #2

Parent/Guardian Email #2

New or returning member in the current year? *

Photo Waiver - I, grant to Athletics Niagara, permission to use images of my child(ren) photographed in the track and field season for purposes of displays, media, website and other purposes in relation to the promotion of Athletics Niagara. I also give consent for the free use of names and/or pictures/video in any broadcast, telecast or website use. *

Membership type

LIVE SUPPORT

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OTHER

2023 ATHLETICS NIAGARA

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