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Grimsby Curling Club

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REGISTRATION FORM FOR THE 2019-2020 CURLING SEASON


Enter registration details

Note that all required fields are marked with **


Enter Contact Details:

First Name: **
Middle Name:
Last Name: **
Gender: **
Address: **

City: **
Province/State: **
Postal/Zip Code: **
Country: **
Home Phone: **
Mobile Phone:
Work Phone:
Ext.:
Member Since: **
Years Curling Experience: **
Email:

Please enter your email address here. Email is the primary method used to communicate with our members and is only used for that purpose. If you do not have an email address please leave this field blank.

Re-enter Email:
Emergency Contact (If youth, enter parent): **
Emergency Contact Phone Number: **
Date of Birth: **
Youth members are required to enter their full date of birth including the year. If you want to take advantage of any available age discounts you must enter your full date of birth including the year.

Consent to Release Information, Privacy Policy and Anti-Spam Policy: **


Injury Waiver: **


Registration Selection: **

Please enter all team member names for choose your own leagues, each team member must submit their own form. Not on a team? Write assign for the other team members.

League Curling

Notes for League Admin (Thurs Daytime Fixed): 

Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 
Alternate: 

Notes for League Admin (Thurs Eve Mens Social): 

Notes for League Admin (BYOT Tues 9:00 AM): 
Skip: ** 
Vice-Skip: ** 
Second: ** 
Lead: ** 
Alternate: 

 


Special Membership Options


Additional Registration Options


Registration Discount Options



Profile / Other Information:

Locker #   

Previous Glendale   

Smart Serve #   

Split Payment **   


Registration Accuracy Confirmation: **



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