1. Registration Information First Name * Surname * Date of Birth (YYYY/MM/DD) * Age * Street Address * City/Town * Province/State * Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ---USA--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ---------------- Other, not listed Postal Code / ZIP * Email Billing Email Address Phone Number * Health Card Number * T-Shirt Size * Adult S Adults M Adult L Adult XL Adult XXL Church Affiliation * GCI Ottawa GCI Toronto GCI Montreal TMH Ottawa Do you have any allergies or health concerns? * Yes No Please describe your allergies/health concerns Emergency Contact 1 Full Name * Emergency Contact 1 Home Phone * Emergency Contact 1 Cell Phone * Emergency Contact 1 E-Mail * Emergency Contact 2 Full Name * Emergency Contact 2 Home Phone * Emergency Contact 2 Cell Phone * Emergency Contact 2 E-Mail * If you are human, leave this field blank.