EmailMe Form - 2016 / 2017 Sexsmith Curling Club Little S

Curling runs Mondays from October 31 to March 13, 2017. We are offering 2 age groups this year!

Grades 3 - 6 Monday 4:30 to 5:30

Grades 7 and up Monday 3:30 to 4:30

Name

First Last

School Grade

Do you have any previous knowledge of curling?

Yes

No

Does the curler have any known allergies?

Yes

No

Please specify allergy.

Does the curler have any medical conditions?

Yes

No

Please specify medical condition.

SHOE SIZE - We are starting a new shoe rental program. Shoes are not guaranteed for all participants. Dependent on availability with preference given to returning participants. Shoe rentals are an additional cost.

Specify Mens/Womens/Kids

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Name

First Last

Relationship

Phone

### - ### - ####

Email

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Would you be willing to volunteer your time to the program?

Yes

No

Maybe

Questions or Comments

I authorize the Sexsmith Curling Club to photograph and video my child, understanding that videos and pictures may be used in advertisements, news stories and various other media.

Yes I consent

No I DO NOT consent

PAID