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 *
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