Super Start Intensity Basketball 2022 Registration Form
January - March (Grades 2-4 (will take lesser experienced grade 5’s)
Childs Name
*
First Name
Last Name
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Secondary Email
example@example.com
Phone Number
*
Please enter a valid phone number.
What School Does Your Child Go To?
*
Child's Age
*
Club 1 & 2 | What sessions are choosing?
*
Monday 4:30 - 5:50 Centennial
Mondays 6:30 – 7:50pm – Laurier Heights
Thursdays 6:00 – 7:20pm – George Nicholson
Did you pay for a Net-Works / Ameba Starr/ Intensity program between August 2020 and June 2022?
*
Yes
No
Use Coupon Code
"Intensity" for 12% Off
Programs
*
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( X )
New Member 1 Class / Week
$
149.00
CAD
Continuing from Fall 1 Class / Week
$
134.00
CAD
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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