GRADES 4 AND 5 - STARTING APRIL 1, 2010 GRADES 6, 7, AND 8 - STARTING MARCH 31, 2010
Name:
Address:
City:
Phone #:
Birthdate:
MONTH January February March April May June July August Setpember October November December DAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YEAR 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Postal Code:
Gender:
Entering Grade:
Male Female
Enter Grade 4 5 6 7 8 9 10 11 12
E-mail Address:
Parents' Names:
Emergency Contact:
Emergency Contact Phone #:
K-W Predators House League 22 Chartwell Court Kitchener, ON N2A 3M1
Make Cheque Payable to "Kitchener -Waterloo Predators"
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