Alberta Freeskiers - Registration

Part of:

Athlete Info
	First Name:
	Last Name:
	Gender:	Male Female
	Street Address:
	City:
	Postal Code:
	Phone #:
	E-Mail:
	Birth date:	Year: Month: Day: Age: yrs
	Years Skiing:
	Have you been coached before ? If so, with what club ?	Yes: No:

	Which Alberta Freeskiers programs are you interested to participate in:	Freeskiers Split Development Punch Card Competitive Dryland Camps Night Riders Events/Competitions

Contact Information
Mother
	Last name:
	First name:
	Home #:
	Work #:
	Cell #:
	Fax #:
	E-Mail:

Father
	Last name:
	First name:
	Home #:
	Work #:
	Cell #:
	Fax #:
	E-Mail:

Guardian
(optional)	Last name:
	First name:
	Home # :
	Work #:
	Cell # :
	Fax #:
	E-Mail :

Authorization of information release I hereby authorize the above information released to Alberta Freeskiers for their records.
Permission granted If you are having problems submitting this page, please download the manual submittion document and email it to us at info@albertafreeskiers.com