Registration Form

Website Access

Email Address for Account:

Choose a Username:

Password:

Retype Password:

Player Details

• Player's Name First Last
• Gender
  MaleFemale
• Date of Birth DD / MM / YYYY






• Player's Home Phone ### - ### - ####
• Player's Cell Phone ### - ### - ####
• Player's Address
  Street Address City Postal Code
• Player's Email Address
• Medical Considerations (Please Describe)
• Mother's Name First Last
• Mother's Email
• Mother's Cell Phone ### - ### - ####
• Father's Name First Last
• Father's Email
• Father's Cell Phone ### - ### - ####
• I give permission for this child to be photographed, videotaped or interviewed by the media or club members during club activities. I understand these pictures/tapes may also be posted on Moncton Badminton Club's website, Badminton New Brunswick's website.
  
  I do not give permission for this child to be photographed, videotaped or interviewed by media or club members.
  
• WAIVER: By checking this box, I waive any claims to which this child may become entitled for injury or damage, and release the Moncton Badminton Club, their coaches, employees and any other person or organization assisting from any claims for damages or injury suffered by the child as a result of the minor participating in or traveling to or from practices and tournaments. I further state that this child is in proper physical condition to participate in this Club, and am aware that participation could in some circumstances, result in physical injury.