Home
WHAT WE DO
Graphic Word
International
Performing Arts
Student Ministry
Trips & Events
QYU Youth Centre
EVENT PAYMENT
WHO WE ARE
ABOUT QYU
Meet the Team
Job Postings
Contact
PARTNER WITH US
How you can Help
Fundraisers
Volunteer
DONATE NOW
Beach Volleyball Camp Registration
Please fill in all the required boxes or it will not submit. Payment is due upon registration. Cheques can bemade out to
Quinte Youth Unlimited or paid online at
www.QYU.ca/pay
. Please
contact our office
directly with any further questions.
*
Indicates required field
Youth Name
*
First
Last
Youth Address
*
Line 1
Line 2
City
State
Zip Code
Country
T-shirt size
*
XS
S
M
L
XL
XXL
Youth Experience Level
*
No experience, trying something new
Just goofing around
Played on school or rep team
Youth Cell Number
*
Youth Email
*
Grade (as of Sept 2018)
*
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Allergies?
*
If none, write "none" or N/A.
Please List Student's Favourite Foods
*
Youth Birthday
*
Parent/Guardian and Emergency Contact Info
Youth Parent / Guardian Name
*
First
Last
Parent/Guardian's Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent Guardian phone
*
There should be space to write multiple numbers here if there are more than one (e.g. each parent's cell).
Parent/Guardian's Email
*
Emergency Contact Name & Phone Number(s)
*
Other Info
Medical Permission: Do you give your permission to Quinte Youth Unlimited to act on your behalf in the event that your child needs medical attention?
*
Yes
No
Media Release: Do you give your permission to Quinte Youth Unlimited to use pictures/videos of your child for the purpose of newsletter, website, print, and any other promotions?
*
Yes
No
Does the child have any physical, mental or emotional disability, chronic condition or recent illness which the staff should be aware of or that may require medical attention?
*
If none, write "none" or N/A
Name of Parent Completing Registration Form
*
How will you be paying the $40 fee?
*
Cheque mailed to Quinte Youth Unlimited
Cash or Cheque dropped off at QYU office: 444 Dundas Street West, Belleville
Credit Card Online at www.QYU.ca/eventpayment
Submit Registration Form!
Home
WHAT WE DO
Graphic Word
International
Performing Arts
Student Ministry
Trips & Events
QYU Youth Centre
EVENT PAYMENT
WHO WE ARE
ABOUT QYU
Meet the Team
Job Postings
Contact
PARTNER WITH US
How you can Help
Fundraisers
Volunteer
DONATE NOW