Sharkx Sports Programs - Registration 2021/2022 Please fill out the form to register your kid(s). Camp FeeHow many children?*123456Select your Sports program* Basketball - 1 trial - 25$ Basketball (250$ - 10 sessions)-Winter 2021 Sports Day Camp - Summer 2022 Basketball program options* Basketball 6-8 years : On Saturdays 1pm-1:55am (indoor) Basketball 9-11 years : On Saturdays 1pm-1:55am (indoor) Basketball 12 years & plus : On Saturdays 2pm-2:55am (indoor) The sessions will be held at the Monkland community Center, 4410 West Hill avenue, NDG.Daycare Service registration?* Yes No Daycare times* Early drop off : 7:30am to 9am (Included) Late pick up : 4pm to 6pm (30$ per week) HiddenAmount of weeks for Late pick-up* 1 Week 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks 7 Weeks 8 Weeks Select your method of payment* E-transfer (monkland.sharkx@gmail.com) Cheque to SHARKX SPORTS PROGRAMS | 5890 Monkland avenue, Suite 16-2 Montreal (QC) H4A 1G2 Discount: 10% off for 1 sibbling maximumRegistration Total $ 0.00 CAD Kid(s) Information Please enter at the required information your child or children.Child 1First Name* Last Name* Gender*Choose a gender.MaleFemaleOtherAge*Date of Birth* MM slash DD slash YYYY Medicare card number* T-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeDoes your child have allergies or specific medical indications?* Yes No Please list your child's allergies or specific medical indications:Child 2First Name Last Name GenderChoose a gender.MaleFemaleOtherAgeDate of Birth MM slash DD slash YYYY Medicare card number Does your 2nd child have allergies?* Yes No Please list your 2nd child's allergiesT-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeChild 3First Name Last Name GenderChoose a gender.MaleFemaleOtherAgeDate of Birth MM slash DD slash YYYY Medicare card number Does your 3rd child have allergies?* Yes No Please list your 3rd child's allergiesT-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeChild 4First Name Last Name GenderChoose a gender.MaleFemaleOtherAgeDate of Birth MM slash DD slash YYYY Medicare card number Does your 4th child have allergies?* Yes No Please list your 4th child's allergiesT-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeChild 5First Name Last Name GenderChoose a gender.MaleFemaleOtherAgeDate of Birth MM slash DD slash YYYY Medicare card number Does your 5th child have allergies?* Yes No Please list your 5th child's allergiesT-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeChild 6First Name Last Name GenderChoose a gender.MaleFemaleOtherAgeDate of Birth MM slash DD slash YYYY Medicare card number Does your 6th child have allergies?* Yes No Please list your 6th child's allergiesT-Shirt SizeSelect a sizeYouth SmallYouth MediumYouth LargeYouth Extra largeAdult SmallAdult MediumAdult LargeAdult Extra largeContact InfoEmail Address* Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Parental Information Please enter at the least (1) parental figure for your child.Full Name Parent 1* Social Insurance Number Mandatory if you want to receive the Rl24 statement.Cell Phone NumberWork Phone NumberFull Name Parent 2 Social Insurance Number Mandatory if you want to receive the Rl24 statement.Cell Phone NumberWork Phone NumberEmergency Contacts Please enter at the least (1) emergency contact for your child.First Name Contact 1* Last Name Contact 1* Phone Number Contact 1*Email Address Contact 1 First Name Contact 2 Last Name Contact 2 Phone Number Contact 2Email Address Contact 2 Sharkx registration consent*Please read the waiver HERE. I agree to the Sharkx waiver.I agree that the Sharkx Sports Programs take and may use photographs of my kid during the program for promotional purposes (social medias, flyers etc.)* Yes No How did you hear about us?* Friends Facebook Google Informer Montreal Families Other Please be specific Your commentsRegistration Total $ 0.00 CAD CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
