Name
Address
City
Province
Postal Code
Home Phone
Email
Date of Birth
Crew, Volunteer or Trainee?
Emergency Contact #1
Relationship
Home Phone
Work Phone
Cell Phone
Emergency Contact #2
Relationship
Home Phone
Work Phone
Cell Phone
Provincial Health Card Number
Height
Weight
Prescription Medications
Medical Conditions
Allergies
Dietary Restrictions
Gender
Can you swim 400m?
Can you tread water for 20mins?
Comments
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