Alberta Northern Lights

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Inferno 2011-2012 Registration Form

Pricing Details

Inferno Membership
None Selected	-
Athlete - Voting - $25	$ 25.00
Non-Athlete - Votin...	$ 10.00
Non-voting - $25 (f...	$ 25.00
Inferno Programs
None Selected	-
CWBL Recreational- ...	$ 100.00
Elite Women's Progr...	$ 100.00

$ 0.00 Total:

Inferno 2011-2012 Registration Form

Please complete the form below to sign up as a member and/or to sign up for specific Inferno programs.

ANL and WSA registrations are separate. The ANL form can be found under links to the left, or at the following link: http://www.teampages.com/forms/146-Alberta-Northern-Lights-2011-2012-Registration-Form

You can bring the outstanding amount in cash or cheque to the gym.

Full Name

Email Address:

Birth Date

Phone Number (home or cell – whichever you check most)

Address:

Street Address:
City: State/Province: Country: Zip/Postal Code:

Program Info

To find out more about ANL, Inferno & WSA programs click on “programs & fees” under “links” on the left of this page

Inferno Programs

CWBL Recreational- $100 Elite Women's Program - $100 (plus $150 assessment per flight) Jurnior (under 22) - Free (assessments may follow if athletes travel)

Permissions

Please contact me with opportunities to volunteer for a Casino or Bingo shift (In order to maintain current programming levels we would need one volunteer shift for each $100 program you sign up for)

I grant Inferno the right to use photos taken of my person for the sole perpose of promoting the sport

Payment Options

If you wish to pay in person, bring cash or cheque (payable to "Inferno Wheelchair Basketball SOciety") to Yvonne Doll at the gym.

or cancel