Club Registration | Norwood Community Centre

Playgroup

$40.00

First half year membership at Norwood Playgroup Wednesday September 25th, 2019 to Feb 5th, 2020

$35 Playgroup fee + $5 Norwood CC fee

Do not add multiple attendees as you will be charged for each one.

First Name

Last Name

Date of Birth (DD/MM/YYYY)

For Team Sports

While every effort will be made to keep your information private, we cannot guarantee security.

Allergies

Asthma

Carries Epi-pen

Dietary Concerns

Other Medical Conditions

Requires Inhaler

Health Information Details

If you checked any of the boxes above, please provide more detailed information.

First Name

Last Name

Address

City

Canadian Province

Postal Code

Email Address

Phone (Day)

Phone (Evening)

Phone (Cell)

I would like to Coach/Assist/Manage