TRACKIE - Online registration for events, tournaments, clubs and organizations...

First Name *

Last Name *

Gender *

Male Female Non-binary

Date of Birth (YYYY *-MM-DD)

/ /

I participate in *

Team *

I am attending this clinic to: *

Learn how to size Getting my chair sized

List 2 Coaches learning how to size *

List 1 athlete who will be getting professionally sized *

Additonal Athlete to be sized

$30.00

QTY

Drive to December Donation (Tier 1)

$10.00

QTY

Drive to December Donation (Tier 2)

$25.00

QTY

Drive to December Donation (Tier 3)

$50.00

QTY

Drive to December Donation (Tier 4)

$100.00

QTY

I have read and agree *
MEMBERSHIP AGREEMENT

I have read and agree *
CONSENT TO USE IMAGE

I have read and agree *
ROWAN’S LAW – CONCUSSION AWARENESS

Digital signature (type your name exactly as entered above "registrants name") *

Wheelchair Sizing Clinic