Freds Registration Fall 2024-25

01. Registrant InformationRegistrants
02. Confirmation & PaymentConfirmation
03. ReceiptReceipt

# of individuals you want to register

* Required fields

First Name *

Last Name *

Gender *

Male Female

Date of Birth (YYYY *-MM-DD)

/ /

School

Address

Email

Phone #

Emergency -- Name

Emergency -- Phone

Doctor -- Nom

Doctor -- Phone

Prescriptions / Medical conditions

Alergies

Medicare -- Number

Medicare -- Expiry

Parent 1 -- Name

Parent 1 -- Phone

Parent 2 -- Name

Parent 2 -- Phone

Duration

Programs *

Duration *

Add another duration

Proceed to next step

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