Athlete's First Name

Athlete's Last Name

Birthdate (DD/MM/YYYY)

Age

Grade

Medical or other conditions that our staff should be aware of:

Parent's First Name

Parent's Last Name

Street Address

City

Postal Code

Primary Phone #

Alternate Phone #

Emergency Contact 1

Phone

Relationship

Emergency Contact 2

Phone

Relationship

Select Your Lesson Time

Select Your 2nd Lesson Time (Save $2 when you sign up 2 or 3 sessions per week)

Select Your 3rd Lesson Time (save $2 when you sign up 2 or 3 sessions per week)

Please Choose Your Method of Payment. Your total training fees and schedule will be forwarded to your email. Fees will be prorated based on how many lessons the Athlete will be apart during the billing cycle.

If you choose e-transfer as your form of payment, please send the payment to our email (pay@eanorth.com) and input the password in the box below (optional)

Send any questions you may have in the box below (optional)