Kelowna Camp Registration

MONDAY AUG 27th to THURSDAY Aug 30th 2012

Two sessions - see below

Use this form to register for Six Pack U please fill it in, and press submit.


Make Cheques payable to :
Six Pack Sports

Mail to :
Six Pack U
1697 Merlot Dr.
Westbank B.C.
V4T 2X4

To pay with a credit card, please indicate so on this form and Dave will contact you by phone for the number. Do not include your Credit card number on this form

 

Mandatory fields are indicated with a *

* Choose payment option: I am sending a cheque
I am paying by credit card
     (please call me)
* Choose Camp:
--- WESTBANK --- --- WESTBANK ---
Elite Half Day ($140)
     for Grades 10 to 12
All Day ($200)
     for Grades 4 to 9
* First Name:
* Last Name:
* Gender: Male
Female
* Date of Birth
Year
Month
Day
* Address :
* City :
* Province or State:
 Please use 2 letter abbreviation
* Country:
* Postal code or Zip code:
* Home phone number: area code: phone:
* Your Email address:
* Your school:
* Grade entering:
* Care card number:
* Emergency contact name:
* Emergency contact phone number: area code: phone:
Medical conditions
we should know
about:
* T-Shirt Size Youth Small (8-10)
Youth Medium (10-12)
Youth Large (14-16)

Small
Medium
Large
X-Large
XX-Large

 

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