Try It Day

Try It Form

This online form is for any participant who would like to try one of our sports.

If you have any questions please direct them to Tara at 587-253-5300 or [email protected].

Participant Information

* Indicates required field

Name of Participant *

First

Last

Email for participant or caregiver *

Phone Number of participant or caregiver *

Birthdate of Participant (Month/Day/Year) *

Address of Participant *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Any health concerns or allergies we should be aware of incase of an emergency? *

Please note that by submitting this application form you are agreeing to the terms and conditions of the waiver

Check this box to confirm you have read and agree to the Waiver presented at the top of this page. If you are a parent or legal guardian please check this box to confirm that you have read, understand and agree to execute the agreement on behalf of child/ward *

Photo Release: I hereby grant Medicine Hat Adaptive Sport and Recreation, including its employees, agents, assigns, or other third partners (Paralympic Sports Association, Wheelchair Sports Alberta, Alberta Cerebral Palsy Sports Association) may authorize on its behalf, the nonexclusive right to:· Photographs and videos taken at any MHASR events to be used in: ·Social Media (Facebook, Twitter, instagram) ·Website promotions ·Promotional and informational distributions

Select One *

Is there any other information that we should know to help you have a successful experience at the try it day? *

Submit