Fall session #2: November 1 - December 19

By Order of the Provincial Health Order we are required to provide the full name, telephone number, or email address, of every participant at Flicka Gymnastics to the North Vancouver Recreation Commission. The information will be retained for thirty days, in case there is a need for contact tracing on the part of the medical health officer, in which case the information must be provided to the medical health officer.
Contact Information
Please enter the contact info for who will be paying the bill. If the student is a minor, please enter the guardian's contact info.

First Name(s) *
Last Name *
Address 1 *
Address 2
City *
Province *
Postal Code *
*
E-mail/Login *(for example: myname@gmail.com)
Additional E-mails(for example: myson@gmail.com, mydaughter@yahoo.com)

Password
Please make a note of your e-mail/login above and the password you enter below. They will be used to log into your account in the future.

Password *
Re-type Password *

How did you hear about us?
More Details

Emergency Contact Information
Who should we contact, other than the contact listed above, in case of an emergency?

Emergency Contact Name(s)
Emergency Contact Phone(s)
* = Required Fields
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