K-Bay Wrestling Registration 2017-18 Season

Contact Information

Please note that any personal or health information will be kept in the strictest of confidence and that this survey is HIPAA compliant for security and confidentiality.

Question Title

* 1. Address

Wrestler's Name

Health Card Number

Address

Address 2

City/Town

Province

Postal Code

Primary Email Address

Primary Phone Number

What grade are you in?

Question Title

* 2. Parent/Legal Guardian Names

Parent/legal guardian name

Parent/legal guardian email

Parent/legal guardian contact number

Parent/legal guardian name

Parent/legal guardian email

Parent/legal guardian contact number