Registration 001_FUN_ACT_registration Number of participants * 12345 Section : Participant - 1 Participant - 1 : First Name * Participant - 1 : Last Name * Participant - 1 : Date of birth * Participant - 1 : Age * Participant - 1 : Does the student have any medical conditions or allergies we should know about? * Yes No Participant - 1 : If yes, specify * Participant - 1 : Choice of pizza (Cheese , Pepperoni) * 2 x slices Cheese 2 x slices Pepperoni 1 slice of each No pizza, thank you! Participant - 1 : Comment Section : Participant - 2 Participant - 2 : First Name * Participant - 2 : Last Name * Participant - 2 : Date of birth * Participant - 2 : Age * Participant - 2 : Does the student have any medical conditions or allergies we should know about? * Yes No Participant - 2 : If yes, specify * Participant - 2 : Choice of pizza (Cheese , Pepperoni) * 2 x slices Cheese 2 x slices Pepperoni 1 slice of each No pizza, thank you! Participant - 2 : Comment Section : Participant - 3 Participant - 3 : First Name * Participant - 3 : Last Name * Participant - 3 : Date of birth * Participant - 3 : Age * Participant - 3 : Does the student have any medical conditions or allergies we should know about? * Yes No Participant - 3 : If yes, specify * Participant - 3 : Choice of pizza (Cheese , Pepperoni) * 2 x slices Cheese 2 x slices Pepperoni 1 slice of each No pizza, thank you! Participant - 3 : Comment Section : Participant - 4 Participant - 4 : First Name * Participant - 4 : Last Name * Participant - 4 : Date of birth * Participant - 4 : Age * Participant - 4 : Does the student have any medical conditions or allergies we should know about? * Yes No Participant - 4 : If yes, specify * Participant - 4 : Choice of pizza (Cheese , Pepperoni) * 2 x slices Cheese 2 x slices Pepperoni 1 slice of each No pizza, thank you! Participant - 4 : Comment Section : Participant - 5 Participant - 5 : First Name * Participant - 5 : Last Name * Participant - 5 : Date of birth * Participant - 5 : Age * Participant - 5 : Does the student have any medical conditions or allergies we should know about? * Yes No Participant - 5 : If yes, specify * Participant - 5 : Choice of pizza (Cheese , Pepperoni) * 2 x slices Cheese 2 x slices Pepperoni 1 slice of each No pizza, thank you! Participant - 5 : Comment Section : Parent/Gardian Name of Parent/Guardian To be completed for those under 18 Main phone * Default communication phone. Primary email * Default communication email. Participation / child Total to pay ($CAD) Choose a payment method * Interac : info@clicsport.ca Cash Captcha Send If you are human, leave this field blank.
