A Day in the Country 2025 Registration
Thursday, July 24, 10am-6pm
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your age:
What health concerns do you have that I should be aware of (state "none" if none)?
*
How did you hear about this event?
Payment options:
E-transfer: Submit this form. Then go to your own banking page and etransfer $254.25 (includes HST) to bgormley@rogers.com
Cheque: Submit this form, then mail a cheque for $254.25 (includes HST) to Barb Gormley, CustomFit, 525 Logan Ave, Suite 103, Toronto ON, M4K 3B3
I understand that I am participating in this physical activity program entirely at my own risk. I assume full responsibility for any and all injuries, losses and damages that I incur while attending, exercising or participating with Barb Gormley/CustomFit. I waive all claims against Barb Gormley/CustomFit, its instructors, or partners of individually or otherwise, for any and all injuries, claims or damages that I might incur.
I understand that there no refunds unless I or Barb finds a replacement for my spot. (Thank you for understanding.)
Signature
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