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FACULTY OF KINESIOLOGY & HEALTH STUDIES RECREATION & ATHLETIC SERVICES
 

Summary: FACULTY OF KINESIOLOGY & HEALTH STUDIES
RECREATION & ATHLETIC SERVICES
R E G I S T R A T I O N F O R M
Date: _____ / _____ / 20__
(DD) (MM)
Last Name: First Name: Birth Date: (dd-mm-yyyy) Grade: Male Female
Street Address: City: Province: Postal Code:
Home Phone: Work Phone: Cell Phone: Email Address:
Parent/Guardian Name: *Parent/Guardian Birthdate (dd-mm-yyyy):*
Emergency Contact (If different than above) Name: Relationship to Child: Phone / Cell:
T-Shirt Size (Summer Sports School & Cougar Athletic Camps, where included)
YS - YM - YL - YXL - AS AM - AL - AXL
* The parent/guardian name and birth date is required to set up the family account and so as not to duplicate accounts. Please include birthdates for all members of an account.*
CRN (s) Program Title Program Dates Course Total
$
$
$
$
$
$

  

Source: Argerami, Martin - Department of Mathematics and Statistics, University of Regina

 

Collections: Mathematics