SKRASTINS GUEST REGISTRATION FORM

GUEST REGISTRATION FORM
Thank you for your interest in Skrastins.

As a first step to becoming a Skrastins guest, please complete the following form. If you have any questions please email your phone number to Pat King, our Bus Coordinator.

king-pd@shaw.ca
First Name*
Last Name’*
Email*
Phone Number*
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Date*

MonthDayYear
Today’s Date
Hour Minutes
Our passion ...
Guest Trip Number*

First tripSecond TripThird trip
Activitiy of Interest*

HikingCross Country SkiingSnowshoeing
Activity Performance Level*

A1A2B1B2 (Default)C1C2
Emergency Contact Name (Required)*
Emergy Contact Phone Number (Required)*
Optional Secondary Emergency Contact Name
Optional Secondary Emergency Phone Number
Park Pass*

I will pay the additional single entry Park entry fee of $10I possess a Park Pass
Park Pass Type*
Park Pass Number*
Park Pass Expiration Date*
MM / YY Format
How did you hear about Skrastins*

InternetMember ReferenceOther ClubSkrastins WebsiteOther
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