Fearless Physical Activity registration
Please complete information below to register for a Fearless Physical Activity event.
First Name
*
Enter the first name of the individual with CHD.
Last Name
*
Enter the last name of the individual with CHD
Email address
*
Address
City
*
Province
*
AB
BC
MB
NB
NL
NT
NS
NU
ON
PE
QC
SK
YT
Postal code
*
Additional family members
*
Yes
No
Are any other family members attending the event with you?
How many attending
Location
*
- Select -
London
Ottawa
Sudbury
Thunder Bay
Toronto
Age (London)
*
- Select -
Child (5-10 years)
Youth (11-18 years)
Adult (>18 years)
London Child Events
*
- Select -
Sunday, January 14th 1- 4pm - Centre Branch YMCA - Final event
London Youth Events
*
- Select -
Sunday, January 14th 1- 4pm - Centre Branch YMCA - Final event
London Adult Events
*
- Select -
Sunday, January 14th 1- 4pm - Centre Branch YMCA - Final event
Age (Ottawa)
*
- Select -
Child (5-10 years)
Youth (11-18 years)
Adult (>18 years)
Ottawa Child Events
*
- Select -
Sunday, February 4th 1-4pm - Taggart YMCA - Final event
Ottawa Youth Events
*
- Select -
Saturday, February 3th 1- 4pm - Taggart YMCA - Final event
Ottawa Adult Events
*
- Select -
Saturday, February 3th 9am-12pm - Taggart YMCA - Final event
Age (Sudbury)
*
- Select -
Child (5-10 years)
Youth (11-18 years)
Adult (>18 years)
Sudbury Child Events
*
- Select -
Sunday, November 19th 12-3pm - Sudbury YMCA - Final event
Sudbury Youth Events
*
- Select -
Sunday, November 19th 12-3pm - Sudbury YMCA - Final event
Sudbury Adult Events
*
- Select -
Saturday, November 18th 1-4pm - Sudbury YMCA - Final event
Age (Thunder Bay)
*
- Select -
Child (5-10 years)
Youth (11-18 years)
Adult (>18 years)
Thunder Bay Child Events
*
- Select -
Sunday, June 4th, 2017 12-3pm - Canada Games Complex
Sunday, September 24th, 2017 12-3pm - Canada Games Complex
Thunder Bay Youth Events
*
- Select -
Sunday June 4th, 2017 12-3pm - Canada Games Complex
Sunday September 24rd, 2017 12-3pm - Canada Games Complex
Thunder Bay Adult Events
*
- Select -
Saturday, June 3rd, 2017 1-4pm - Canada Games Complex
Saturday, September 23rd, 2017 1-4pm - Canada Games Complex
Age (Toronto)
*
- Select -
Child (5-10 years)
Youth (11-18 years)
Adult (>18 years)
Toronto Child Events
*
- Select -
Sunday January 21st, 2018 1-4pm - Variety Village - Final event
Toronto Youth Events
*
- Select -
Sunday January 21st, 2018 1-4pm - Variety Village - Final event
Toronto Adult Events
*
- Select -
Sunday January 21st, 2018 1-4pm - Variety Village - Final event
Restrictions
List any restrictions or limitations
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