Individual Registration and Health Form

Individual Registration and Health Form

Please fill out your personal and health information below. Please submit before February 28th, 2026.
Registration Information
Participants Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
NoYes, just myselfYes, with my spouse or companion
Select your Division and Team*
Tournament Division*
Team Name: If not in list please contact us using the contact us form*
Health Form
I am solely responsible for my own medical, liability and personal insurance.
Do you have any allergies or special needs? (none, glutens, etc.)*
Do you have any chronic illnesses or medical conditions? (eg. none, Diabetes, Heart)*
Are you currently taking any medications? ( eg: none, heart - name drug)*
Family Doctor's Name*

First NameLast Name
Doctor's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
The information on this form will be kept under strick control and only made available to emergency personnel. By submitting this form, I authorize it's use by emergency personnel and it's destruction by the organizing committee after completion of this tournament.
Should be Empty:

Registration Information