Form
Winter Comforts with Melanie J
Tues, Dec 9 from 6-8 PM
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
I understand that this registration form saves my spot until Dec 4. I can come in and pay ($45) at the Centre with cash, credit or debit card prior to Dec 4. If I can't make it by then, I will contact Brandi@fsjfs and make arrangements, or cancel my spot.
*
Please Select
yes, I agree
Date of Birth (only year is required for statistics) - you can enter Jan 1 if you don't wish to divulge actual birth date
*
-
Month
-
Day
Year
Date
Ethnicity- everyone welcome but again- stats ;)
*
Please Select
First Nations
Métis
Inuit
Not indigenous
Do not wish to disclose
Tea and light snacks will be served. Please indicate allergies here:
*
Submit
Should be Empty: