Dive Toronto

Dive Toronto
29 Bermuda Ave.
Etobicoke ON
M8Y 2P6

Participants Name: .............................................................................................................

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Telephone#  Day (.......) ................................     Evening (.......) .......................................

Date of Birth: .................................................     Age: ........................................................

Parents Names: ..................................................................................................................

E-mail Address: ..................................................................................................................

Class Day & Time: ..............................................................................................................

Allergies / Health Concerns: ...............................................................................................

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Health Card Number: ...........................................................................................................

 

Fee: ........................... cash / cheque (payable to "Dive Toronto")

  1. If registration is insufficient to run this class, your money will be refunded. If you wish to cancel your registration, you must do so prior to the first class. A $10.00 cancellation fee will be charged. No refund after the second class.
  2. Dive Toronto will provide every safeguard for the health and welfare of each participant but will be released from all  actions, dangers, claims, and demands whatsoever arising out of participation of the persons so named in the program stated above.

Date:         ...........................................................................................................................    


Signature: ...........................................................................................................................