Printable Registration Form - HIES

Please fill out a form for each person and each class.

Program: _____________________________________________________________________
Applicant Name: _______________________________________________________________
Phone Number: ________________________________________________________________
Emergency contact: ___________________________________________________________
Emergency phone: ______________________________________________________________
Is there anything we need to know about you?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

I _________________________________ absolve the Hornby Island Educational
Society and any related organizations for any injuries incurred during my
participation in this class.