Coloured Shirt Program Centre Registration
Club/Association Name
*
Program Coordinator Name
*
First Name
Last Name
Program Coordinator Contact Email
*
example@example.com
Program Coordinator Contact Number
*
Please enter a valid phone number.
Which season are you registering for?
*
Please Select
Autumn
Winter
Spring
Summer
Postal Address (If shirts/resources need to be sent out, shipping costs may apply)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list any mentors that your club/association has for the season
Submit
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