WLAC Registration Form

Please bring this completed form to the first practice along with payment payable to WLAC

Name______________________________________________________________________

Age______________ Date of Birth ( DD / MM / YY )

Address____________________________________________________________________

___________________________________________________________________

Phone Home_______________________________ Cell_____________________________

Work_______________________________ Cell_____________________________

Parents or Guardians__________________________________________________________

Heath Card #_______________________________

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Membership Options

1. Inclusive Year Membership (Includes all programs and OTFA fees)

First Time Member $300.00 ____________________

Bantam $315.00 ____________________

Midget/Juvenile $335.00 ____________________

Junior/Senior $345.00 ____________________

Masters $270.00 ____________________

Non_Competitive $280.00 ____________________

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Sessional Registration (pay as you play)

2. Fall Training Program/ X-Country $60.00 ____________________
(September 25-November 22 2 x’s per week)

X-Country Only $40.00 ____________________ (September 3-November 20 1x's per week)

3. Winter Training Program $120.00 ____________________
(November 27-March Break 2x’s per week)

Pool Work Outs 1 x per week $80.00 ____________________

Indoor Track Western 1 x per week $60.00 ____________________

4. Summer Training Program $100.00 ____________________
(May 23-August 11 3x’s per week)

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OTFA Fees

OTFA fees are NOT included in individually priced program

First Time Member_____________ $30.00

Junior/ Senior_________ $85.00

Bantam_______________________ $40.00 Master________________ $5.00

Midget/Juvenile________________ $70.00

Non-Competitive______ $10.00