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brockvillelegiontrack@gmail.com

613-640-0392

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BROCKVILLE LEGION TRACK AND FIELD CLUB

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Nonprofit Organization · Sports Team

Online Registration for Indoor Season 2022/2023

Athlete Name

Parent Name

Email

Secondary email (optional)

Address

Contact Phone Number

Athlete Birthdate

Does the athlete have any medical conditions? If so, please provide details below or enter N/A

I give permission for my child as named above, to participate in the Brockville Legion Track and Field Cross Country/Track and Field Program.

I give permission for my childs image to be used in social media and club website images.

Thank you for filling out the registration form! Please note that your registration is not complete until payment is received. We look forward to seeing you at practice!

Thanks for submitting!

613-640-0392

brockvillelegiontrack@gmail.com

125 Stewart Blvd Brockville ON Canada

©2021 BY BROCKVILLE LEGION TRACK AND FIELD CLUB.

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