three60five Registration

three60fiveJUNIOR2023

"*" indicates required fields

Registering As...*

Name*

First Last

Grade*

Grade you will be entering Fall 2023

Gender*

Address*

Street Address Address Line 2 City Province Postal Code

Phone

Email*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Which church or youth group are you coming with (if applicable)?

Roommate Preference

(1 only, no guarantee)

List Medical Concerns

Health Card #

List Allergies

Payment Amount*

Payment Method*

Registration is not considered to be complete until payment has been received. Cheques must be postmarked on or before Sept. 22 in order to receive the early bird fee.

Parent/Guardian/Adult (aged 18+) Name*

This field is for validation purposes and should be left unchanged.

Registration Form

three60fiveJUNIOR2023