Class Registration | Leadership Matters

Class Information

The class information below was brought over from the page you clicked "REGISTER NOW!" on. If this is not the class you're wanted to register for, please visit the Class Listing page, choose the class you want and then click the "REGISTER NOW!" button.

Class Name:*

Class Start Date:*

Participant's Name:*

You can add more than one participant (up to 5) by clicking the + icon to the right of the name field.

Dietary Restrictions or Allergies:

Please list any dietary restrictions or food allergies each participant listed above.

Alberta Health Care (AHC) Number:*

Please enter the name and AHC number for each participant added above.

Name	AHC

Parent or Gaurdian Full Name:*

At least one parent or legal guardian must provide full contact information.

Relationship to Registrant:*

Full Address:*

Phone Number:*

Email Address:*

Family Doctor's Information:*

Please provide a name and telephone number for each registrant's family doctor.

Your Full Name:*

Your Relationship to the Registrants:*

Your Email Address:*

How did you find out about these classes/camps?*

Google (Internet search)
Friend
Community Association website
Leadership Matters website
Other

If other, please let us know:*

Method of Payment:*

We currently accept Email Money Transfers (preferred method) or cheque.

Payment in full is required at the time of registration. Fees are non-refundable except for verified medical or family emergencies in which case paid fees less 25% will be refunded.*

I Agree

I hereby give permission to staff at Leadership Matters Consulting Services for taking photos of my child during camp which could be used on their website or future brochures, including the first name of the student and/or their parent.*

Yes
No

Disclaimer and Agreement

By clicking “SUBMIT” I, the Parent/Guardian hereby give Leadership Matters Consulting Services and their representatives from Liability for any accidents or injuries that may occur while my child(ren) is/are involved with (Good Manners Rock Camp OR Youth Leadership Classes).

I agree to the above disclaimer and agreement:*

I Agree

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