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Prénom *

Nom *

Sexe *

Homme Femme

Date de naissance (AAAA *-MM-JJ)

/ /

Adresse postale - Adresse *

Adresse 2

Ville *

Province / État *

Pays *

Code postal *

Adresse e-mail * Recevoir des courriels

Phone Number * - Téléphone international

Emergency Contact (Full Name) *

Emergency Contact (Relation to Athlete) *

Emergency Contact (Mobile phone) * - Téléphone international

Emergency Contact (Email) *

Medical Insurance Number *

MEDICATIONS: Please (a) list any medications that club staff should be made aware of and (b) the reason for said medications. This information will remain confidential between coach and athlete. Enter "None" if you are not taking medications currently. *

INJURIES: Please list any injuries that club staff should be aware of. Please indicate the date of any recent injuries. This information will remain confidential between coach and athlete. Enter "none" if there are no injuries. *

CHRONIC CONDITIONS: Please list any chronic conditions that club staff should be aware of (ie: Diabetes, Epilepsy, Heart Conditions, etc). This information will remain confidential between coach and athlete. Enter "None" if there are no conditions to note. *

VOLUNTEERING: The Kajaks Family Volunteers and all Masters athletes are required to commit to a minimum of 20 hours of volunteer work to support club activities. Athletes who are not able to complete those hours will be invoiced at the end of the June at a rate of $10/hour for outstanding hours. *

Type d’adhésion

Catégorie *

2025 KajaksTFC Masters Athlete ANNUAL membership (35+)

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Type d’adhésion