Enfant/Child

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Summer Camp

Flag Football

Private Training

Basketball

Nom/Last Name

Prénom/First Name

Courriel/Email

Téléphone/Téléphone #

Adresse/Address

Ville/City

Code postal/Postal Code

Genre/Gender

Date De Naissance(A/M/D)/Birthday(Y/M/D)

Surnom/Nickname

Instagram Account

Code Promo/Promo Code

Code Promo/Promo Code

Parent/Parent
Nom du parent/Parent Name	*Required
Numéro de contact /Contact Number	*Required

6234

Fill in the value as shown above: