MAJ - Seniors program registration

New Horizons

Seniors Program Registration
Registration conditions

1. At the time of registration you'll be 65 years or older in the year 2025.

2. Your partner can accompany you provided one of you will be be 65 years or older in the year 2025.

3. Your participation in the program is free of charge unless specified.
I am 65 years or older*

YesNo
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
How are you attending?*

AloneCouple
Partners Name*

First NameLast Name
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
You do not meet the criteria to attent this event, please exit.
Should be Empty: