Nelson Gymnasium Registration
Nelson Gymnasium Registration
Name
Name
*
First
Last
Date of Birth
**Please note all patrons under 16 years old must be accompanied by a parent/guardian at all times while using the facility.**
Date of Birth
**Please note all patrons under 16 years old must be accompanied by a parent/guardian at all times while using the facility.**
*
/
MM
/
DD
YYYY
Demographic Type
*
Current Selkirk Student
Staff/Retired Staff
Community Youth (0-18)
Community Adult (19-59)
Community Senior (60+)
Selkirk College Student Number (if applicable)
Email
*
Phone
Phone
*
-
###
-
###
####
Which email lists would you like to be added to? Check as many as apply.
Which email lists would you like to be added to? Check as many as apply.
Yoga
Soccer
Badminton
Volleyball
Cricket
Basketball