2013-2014 Junior Curling Registration Form

2013-2014 Intermediate/Junior Curling Registration Form

Registration fee: $90.00

Time: Saturday 3:45 pm

Curler Data:

Name:__________________________

Address:___________________________

Phone:_____________

Birth Date:

Day:_____

Month:_________

Year:_______

Age as of December 31,2013______

Parents Names:

Father______________

Mother______________

Team Formation: (Leave blank if you wish to be placed onto a team.)

I would like to curl with
______________________	______________________	_____________________

Method of payment:

Cash_____

Cheque_______

Date Paid__________________

Parent Signature:_______________________
(Curler signature if 18 or more years old)