|Organization: Whistler Blackcomb Freestyle Ski Club|
|Date of Birth:||Nov 12, 1995|
|Emergency Contact Name:||+17148680120|
|Emergency Contact Phone #:||+17148680120|
|Health Care # or Insurance Policy #:||4354356|
|Please list any medical/allergy/dietary concerns or previous injuries the coaches should be aware of:||4354356|
|I give my consent to allow WBFSC to use these images:||Yes|
|Name of Person Agreeing to this Film/Photo Consent:||movies|
|I acknowledge that I have read and accept the above waiver:||Yes|
|Name of Person Agreeing to this Release of Liability:||movies|
Total Due: (CAD)
|A copy of this receipt has been e-mailed to firstname.lastname@example.org|
Thank you for registering for the Airbag Programs
Please meet your coach at the Airbag 10 minutes before your session starts.
Note that all participants need: helmet, non-broken ski edges and to listen to the coaches directions. Failure to do so will result in removal from the session.
Questions regarding registration can be forwarded to email@example.com