Les
Aventuriers de Charlo Inc.
Registration form 2005-2006
Basic costs: (HST included in prices)
Early bird
before and incl. Dec. 4
2005 After
Dec. 4 2005
Family $145 $160
(includes children under 17)
Adults $
80 $
90
Students
< 17/Children $
50 $
60
Seniors $
70 $80
Additional
programs:
Jackrabbit*-
1 child $ 35 Kick off date:
Dec. 4 2005
Jackrabbit*-2
or more children $ 55
Biathlon**-
1 or more athlete $ 50
·
In order to register
with the jackrabbit program, the child must be a member of
Les Aventuriers. However,
children registering for level 1 and 2 will be accepted
in the program without membership.
** In order to register for the biathlon,
athletes must be members of the
Les
Aventuriers ski club.
……………………………………………………………………………………………………………………………………………………………………
Name :___________________ Date of
birth :____________________
Address: _________________________
_________________________
_________________________
Telephone:
_____________________ E-mail:
_______________________
Other
family members:
Names: Date
of birth:
________________________ ________________________
________________________ ________________________
________________________ ________________________
Special
interests:
Ski
classes classical technique ___ Jackrabbits ___
Ski
classes skating technique ___ racing ___
Volunteer
for the club ___ others ___ Specify:_________
In
consideration of Les Aventuriers de Charlo Inc. accepting the membership of the above
Named
participant(s) as member(s) I, the undersigned, participant and/or
parent/guardian of the said participant, herby for myself, my heirs, executors,
administrators and assigns, agree to release and to indemnify and save harmless
Les Aventuriers de Charlo
Inc., its servants, agents, sponsors, or employees from any and all claims and
demands whatsoever, which might be made against Les Aventuriers
de Charlo Inc., arising out of or in consequence of
the above named participation in the above named activities notwithstanding
that such claims or demands may arise out of negligence of Les Aventuriers de Charlo Inc., its
servants, agents, sponsors or employees.
Dated
at ________________________this ___day of ________20___
Participant:____________________ Parent or
Guardian:___________________________