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Participant Information
Participant's First Name
*
Participant's Last Name
*
Age
*
T-Shirt size
Y Small
Y Medium
Y Large
Y X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Participant's Medical Conditions
Parent/Guardian Name (First and Last)
*
Phone Number
*
Postal Code
*
Primary Email
*
Primary Email Confirmation
*
Secondary Email address (optional)
Emergency Contact
*
Emergency Contact Phone
*
Special Requests or other Relevant Information
FALL 2023 Programs
Multi-Sport:Basketball/ Soccer [$175- includes T-shirt]
🛈
Ages 5-12: Tuesdays from 6:00-7:00, Sept 19-Oct 24 @ REAL Sports Barn (Avana Centre)
Pickleball [$175, includes T-shirt]
🛈
Ages 7-12: Wednesdays from 6:00-7:00, Sept 20-Oct 25 @ Queen City Pickleball Hub
Martial Arts [$175, includes T-shirt]
🛈
Ages 5-12, Saturdays from 3:00-4:00, Oct 21, Nov 4, 18, 25, Dec 2, 9 - Nov 18 @ Spirit of the Dragon
Permission/Liability Waiver
Girls in the Game Permission/Liability Waiver
Permission/Liability Waiver
*
By checking this box, I am acknowledging to have read the Girls in the Game Permission/Liability Waiver and am in agreement with its terms and conditions.
Email Consent
*
By checking this box, I am consenting to receive emails from Girls in the Game and ICANPLAY Sports with my program information and about upcoming programs.
Photograph Permission
By checking this box, I am giving permission to Girls in the Game to take photographs of my participant for promotional and website use. The names of participants will not be published.
How did you hear about our program?
*
I'm a previous participant!
School Flyer
Billboard - Walmart North
Billboard - Arcola East
Billboard - Other
Poster - please indicate location
Poster - Sandra Schmirler
Metro News Ad
Captive Audience poster
Regina Flag Football
Other - please specify
Other:
To complete your registration, please select GST
*
GST
Coupon Code