MIFA FIT WOMENS Bootcamp Registration

$159.99 +HST

Participant Information

First Name & Last Name^*

Address

Home Phone^*

Birth Date^*

Email^*

Gender

Male
Female

Medical History^*

Medical/Emergency Contact Information

Emergency Contact^*

Phone^*

Relationship to Player^*

By submitting this form you confirm that you have read and understood the following: I agree to abide by the rules, Code of Conduct and regulations of MIFA and conduct myself in a sportsmanlike manner during all MIFA programming and events. I agree that the Participant named above will not be permitted to participate in any programs until an application form and insurance waiver have been signed, all other documentation has been provided, and the required fees paid. I acknowledge that MIFA DOES NOT PROVIDE A REFUND FOR ANY FEES PAID.

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Participant Information

Medical/Emergency Contact Information

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