registration form-basketball tournament (2)
Post on 21-Apr-2015
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For You Telecare Family Service 1133 Leslie Street, Suite 211 North York, Ontario M3C 2J6
Tel & Fax: (416) 447-3535 Crisis Line: (416) 241-5456
E-mail: info@futfs.org Web: www.futfs.org
“ Youth Basketball Tournament” Note: All information is confidential and will not be released without your permission
*REGISTER Date: / / MM / DD / YY
Name: __________ Last First Middle
Gender: M ( ), F ( ) Date of Birth: / / Grade: ( ) MM / DD / YY
Address: City Postal Code
☎: (H): (B): (C):_ ______
E-mail: ___________________________________________________________________
Emergency Contact: Relationship:
Name: Tel: Team Members (Team name : )
Name Grade Date of Birth MM / DD / YY
_ MM / DD / YY
__ MM / DD / YY
Registration Fee
Fee : $ 5 per player Signature: Date:
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